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hnuary 1967 



: 

SCHOOL OF I 

OTTAWA, ON?.. 
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anadian 
urse 





habilitation 
of thalidomide 
children 

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tax revisions 

varicosities 

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Each added 
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Materials go to 
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IARY 1967 THE CANADIAN NURSE 1 




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2 THE CANADIAN NURSE 



JANUARY 1%: 



The 

Canadian 
Nurse 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses Association 




Volume 63, Number 1 



January 1967 



26 Habilitation of Thalidomide Children: 

The Nursing Approach M. O Brien, M. Owens, and J. Ralph 

29 Impact of Cerebral Palsy on Patient 
and Family 



32 Recent Advances in Heart Surgery 

36 Intensive Care Unit in Cardiovascular 
Surgery 

39 Varicose Veins of the Lower Limb 
43 Nursing Care in Varicose Vein Surgery 

45 Effectiveness of Nursing Visits 
to Primigravida Mothers 

50 Project Bed Rest 



W.A. Hawke 

P. Grondin and C. Meere 

C. Boisvert 

P. Dionne 

M. Rodrigue 

L.S. Brown 



L. Dahl, M. Smith, B. Fowle 
J. Hutchison, R. Graham, and D. Black 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses Association. 



4 Letters 
7 News 
16 Names 

22 New Products 

23 Dates 



25 Editorial 

53 Books 

55 Films 

56 Accession List 
i 1966 Index 

ii Official Directory 



Executive Director: Helen K. Mussallem . 
Editor: Virginia A. Lindabury . Assistant 
Editor: Glennls N. Zilm . News Editor: June 
I. Ferguson . Editorial Assistant: Carla D. 
Penn . Circulation Manager: Pierrette Hotte . 
Advertising Manager: Ruth H. Baumel . Sub 
scription Rates: Canada: One Year, $4.50; two 
years, $8.00. Foreign: One Year, $5.00; two 
years, $9.00. Single copies: 50 cents each. 
Make cheques or money orders payable to 
The Canadian Nurse . Change of Address: 
Four weeks notice and the old address as 
well as the new are necessary. Not respon 
sible for journals lost in maii due to errors 
in address. 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on wnite paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
Authorized as Second-Class Mail by the Post 
Office Department, Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4, Ontario. 

Canadian Nurses Association, 1966 



JANUARY 1967 



An item appearing recently in 
a French-language newspaper 
reports that married women in 
Sweden are seriously questioning 
whether it is worth their while to 
seek gainful employment. 
Apparently income taxes are in 
creased disproportionately when 
more than one member of the 
family brings home a paycheck. 
Moreover, the Swedish women 
complain that child care costs, a 
necessary expense for working 
mothers with young children, 
cannot be deducted from income 
tax. 

Similar deterrents to employment 
of married women are found in 
Canada. The income tax structure 
was organized at a time when the 
man in the home was the sole 
breadwinner, and has not been 
revised to keep apace of the 
changing role of women in 
the economy. 

After examining present income 
tax policy as it pertains to married 
women, we became convinced that 
its irrelevancies could be discussed 
adequately only in a full page 
editorial (page 25). 

We believe that a revised Income 
Tax Act that recognizes the role 
of married women in the labor 
force will benefit the country s 
economy as well as individuals and 
their families. We realize, also, 
that taxation procedures inflict 
hardships on many different groups 
within the labor force. In this 
article we are dealing primarily 
with married women who are 
nurses, because we believe that 
anything that inhibits the re-entry 
of professional nurses into a 
practice already short of practition 
ers is detrimental to Canadian 
health services and to Canada. 

Editor. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters will be considered for publication 

Name will be withheld at the writer s request. 



Nurgents? 

Dear Editor: 

I was delighted to read in your October 
issue that male nurses are likely to be wel 
comed into the study and work of obstetrical 
nursing. 

Seventy years ago I started my nursing 
career in the Samaritan Hospital for Women 
in Glasgow, Scotland and I learned a lot 
that was good to know about women and 
also men. Very soon I felt angry that male 
nurses in military hospitals were called 
"orderlies." I know how kind men can be 
and, even with their extra strength, how 
gently they can handle patients - - often 
better than women. Has anyone thought 
of calling them "nurgents?" With every good 
wish for your magazine. Jean McMartine 
Weir, B.C. 



Dear Editor: 

We were interested to read the article 
"Why not obstetric nursing for male stu 
dents?" (October 1966.) 

As we are men in nursing, we are pleased 
to see articles such as this appearing in 
the magazine. We were surprised to learn 
that only an estimated 60 percent of male 
nurses have had obstetrical nursing exper 
ience. We agree that the rationale for this, 
"that the obstetrical patient would be embar 
rassed if a male nurse attended to her nurs 
ing care needs" is not sound. We wonder 
how these schools reason that women who 
have had male nurses attending to them in 
the caseroom, would be more embarrassed 
in the postpartum period. 

There are six men enrolled in the nursing 
course at the Regina Grey Nuns School of 
Nursing, Regina, Saskatchewan. Two are 
presently in obstetrical nursing. It is man 
datory that we take the full obstetric course, 
theory and practice. 

We perform total nursing care anti- 
and postpartum, with the exception of peri- 
neal care. We will also be having the reg 
ular experience in the caseroom, nursery 
and premature nursery. 

We have exprienced complete acceptance 
by the mothers and the present ward staff. 

We are convinced that all schools of nurs 
ing should attempt to prepare all their stu 
dents, male or female, to be fully qualified 
with a basic understanding in all nursing 
areas. Dave Hunter, R.P.N., and Bill 
Ayotte, R.P.N., senior nursing students, 
Regina Grey Nuns School of Nursing, 

Reciprocity wanted 

Dear Editor: 
We are concerned with the provincial 

4 THE CANADIAN NURSE 



and international re-registration of nurses. 
It seems to us that pettiness and nastiness 
abound. How about action on international 
registration ? 

We are all members of the International 
Council of Nurses, and each delegate is 
recognized as a professional nurse. Is it not 
odd that we should find such difficulty in 
accepting each other outside Geneva? 

We suggest a blitz here and now: All 
Canadian nurses should apply for registra 
tion in at least one other province and one 
other country. This action would give the 
individual nurse experience with this pro 
blem; she would also discover that nurses 
around the world are more alike than dif 
ferent ! 

With this experience, nurses would be 
eager to change the laws that presently bind 
us, and it could provide the impetus to 
break the existing hiatus. Bob Brown, 
R.M.N., S.R.N., Reg.N., and Phil Gower, 
Reg.N., The University of Western Ontario 
School of Nursing, London, Ont. 

Unwed Father 

Dear Editor: 

Attention is continually being focused on 
the unmarried mother her problems, 
fears, and responsibilities. I believe it is 
time that an investigation be made into the 
role of the putative or unmarried father. 
Granted, he can escape from the situation 
more easily than an unmarried mother, but 
he does not escape from those problems 
that caused his behavior in the first place. 

The putative or unmarried father is a 
man who produces a child as a result of 
intercourse out of wedlock and who subse 
quently fails to marry the mother before 
the birth of the child. 

Until recently, the only consideration given 
to the problems of the putative father has 
been from a moral standpoint. The psycho 
logical aspects are now coming under in 
vestigation. A boy guilty of promiscuous 
behavior may be using girls to satisfy needs 
that were neglected in his early upbringing 
- needs for affection, attention, indepen 
dence and acceptance. Other theories suggest 
that the putative father, although so insecure 
that marriage would be unthinkable, pro 
duces a child to prove to himself that he is 
ready for marriage. 

Society seems to regard the unmarried 
father as a man who has "let the woman 
down" by not marrying her. This is often 
the case, but there are also many cases in 
which the boy would be willing to marry 
the girl but she refuses or her parents will 
not allow it. In other cases the couple 



mutually agree not to marry. 

Looking on the financial side of things, 
there is the unmarried father whose cons 
cience is headed by cash settlements. When 
this prostitute pattern is brought into the 
picture, the child becomes only the mother s 
in the sight of both parents. 

In contrast, there are men with true 
parental feeling for whom a cash settlement 
would do nothing but increase their sense of 
guilt. In the case of a young man who 
knows enough of modern psychology to 
realize the effect of deprived parenthood on 
a child, this sense of guilt may have a des 
tructive effect on his later relationships with 
his legitimate children. 

The unmarried father will find it hard 
to go to a welfare office for help. He 
always expects severe treatment or at least 
trouble. Knowing that society still regards 
him in a criminal light, he tends to stay 
away from any official person or body no 
matter how much he needs help. It is easy 
to see that some of the apparent irresponsi 
bility of the unmarried father is due to the 
fear he has of social censure. He particularly 
distrusts women social workers because he 
does not think that they will understand the 
man s point of view. 

I believe that if the many mysteries sur 
rounding the unmarried father are to be 
removed, society must adopt a new attitude. 
Instead of isolating the putative father, it 
should treat father, mother, and child as an 
originally linked problem. Only with such an 
approach can society avoid the increasing 
number of adoptions and help to establish 
new families from people who originally saw 
nothing ahead but a life filled with problems 
that they could not solve. Miss Helen 
Staaf, intermediate nursing student, Royal 
Columbian Hospital, New Westminster, B.C. 

Unfair to blame nurses 

Dear Editor: 

I just read the distressed reader s letter 
in the November issue, complaining about 
the indifference of a nurse toward her while 
she was in labor. 

I do not like to see a hospital described 
as turning out poor nurses as the reader 
implies in her letter because I think that 
rather the opposite is true; nor do I like 
to see somebody jumping to the conclusion 
that all nurses are bad nowadays, because 
one nurse possibly slipped up somewhere. 
I said "possibly" because, after all, the nurse 
probably had her instructions from the doc 
tor, and they might well have been different 
from what the patient thought they were. 

Any nurse who has worked in obstetrics 

(Continued on page 6) 

JANUARY 1967 




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JANUARY 1967 



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THE CANADIAN NURSE 5 



letters 



(Continued from page 4) 

has come across the case where the doctor, 
for various reasons, does not want to give 
anything for pain until he absolutely has 
to. And furthermore, where was the lady s 
doctor? Did he induce labor at night! 
and then go home? And did he phone back 
or come in person to check his patient s 
progress? She says nothing about that. 
I think it is most unfair of her to put 



all the blame for her neglect, if there was 
any, on the nurses. They were probably 
overworked, and expected her, of all pa 
tients, to have understanding in the situation. 
The only thing that bothers me in that letter 
is that the nurse who came on duty at 11:30 
P.M. did not go in to check the patient. 
Probably there was a good reason why she 
didn t, but it would have been better if she 
had. Above all, it would have reassured the 
patient to know that somebody was keeping 
an eye on her. From the tone of the letter it 
seems obvious that reassurance was what she 
needed most. Mrs. M.E. Mueller, R.N., 
North Battleford. Saskatchewan. 




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6 THE CANADIAN NURSE 



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Refresher course in Manitoba 

Dear Editor: 

In answer to the letter from "R.N. Mani 
toba" and her comment regarding refresher 
courses (September 1966): St. Boniface Gen 
eral Hospital will be conducting its fourth 
six-week refresher course in February and 
early March of 1967. 

Any nurses from the Winnipeg area inter 
ested in this course can obtain more infor 
mation by writing to the Co-ordinator, In- 
service Education, St. Boniface General Hos 
pital, St. Boniface, Manitoba. (Mrs.) K. 
De Jong, Winnipeg, Manitoba. 

Compliments 

Dear Editor: 

We have noticed with great pleasure the 
numerous innovations which have been in 
corporated into both The Canadian Nurse 
and L infirmierc canadienne. 

Furthermore, we appreciate that the 
French edition is not a word for word 
translation of the English. 

We would like to congratulate each and 
every member of the editorial staff, hoping 
that they will keep up their enthusiasm in 
order to maintain the spirit of the magazine 
and make it even livelier. Sister Claire 
Bilodeau, Director of the School of Nursing, 
Hopital du St-Sacrement, Quebec. 

Dear Editor: 

Every month after reading THE CANADIAN 
NURSE I think that I should write to ex 
press my appreciation for the very fine 
issues we are receiving. I have procrastinat 
ed long enough, so here are my sincere 
thanks for a difficult job well done. 

This letter was prompted by the opinion 
expressed by Dr. R.W. Sutherland in his 
article "Needed: Nurses Who Are Clinical 
Specialists" (Sept. 1966). I agree with 
every word he wrote. K. Deathe, Toron 
to, Ont. 

Dear Editor: 

The Nursing Sisters Association of Can 
ada, Montreal Unit, express appreciation and 
thanks for the articles and photographs 
published in the November issue. 

Greetings and good wishes to the staff 
of THE CANADIAN NURSE. Nancy Kennedy- 
Reid, National President and I. O Reilly, 
President, Montreal Unit. 

Dear Editor: 

I have just received the September issue 
of THE CANADIAN NURSE. I am an Alberta 
graduate and am currently registered in B.C. 

The new concepts that are prevalent in 
nursing today never cease to amaze me. 
I am proud to say I am a nurse, and also 
a Canadian. 

Keep up the good work, we all can learn 
from one another. E.M. Harrison, R.N., 
Chemainus, B.C. D 

JANUARY 1967 



news 



Dublin-Born Nurse 
to Study in Canada 

Sister Gene vie ve, S.R.N., principal tutor 
at the Mater Infirmorum Hospital, Belfast, 
will study nursing education in Canada as 
a result of winning the 1966 Glaxo Scholar 
ship administered by the British Common 
wealth Nurses War Memorial Fund. 

This is the eight successive year that 
Canada has been chosen by a Glaxo Scho 
lar as a training center. 

Sister Genevieve, who was presented with 
her award by Queen Mother Elizabeth at a 
birthday reception at St. James s Palace to 
celebrate the 21st anniversary of the Fund, 
will arrive in Montreal early in April. She 
will study post-basic courses in obstetric 
nursing, operating room nursing, and 
psychiatric nursing at the Royal Victoria 
Hospital. 

The 500 scholarship will also take her 
to Toronto, New York, Washington, D.C., 
St. Louis, San Francisco, and Chicago. 

The Glaxo Scholarship is one of several 
available through the British Commonwealth 
Nurses War Memorial Fund. It was set up 
in 1945 as a memorial to the 3,000 nurses 
and midwives of the British Commonwealth 
who lost their lives in the Second World 
War. The Fund has to date sponsored over 
150 scholars and two research fellows. 

UWO School of Nursing 
Sponsors Fifth Seminar 

To assist senior nursing executives toward 
better job performance, the school of nursing 
of the University of Western Ontario has 
arranged an 11 -day seminar June 12-23, 
1967. 

Sessions are planned for six days, Monday 
through Saturday noon the first week; for 
five days, Monday through Friday afternoon, 
the second week. Featured speakers will 
include Mother M. St. Michael, professor of 
philosophy, Brescia College, UWO; Dr. 
Catherine M. Norris, nurse educator and 
author, formerly professor of nursing at 
the University of New Mexico; Dr. R. Hodg 
son, associate professor of the school of 
business administration, UWO; and Dr. 
Elizabeth Hagen, professor of psychology 
and education at Columbia University. 

Interspersed throughout the two-week 
program will be lecture-discussion sessions, 
group analyses of cases, films, role-playing 
and individual guided study. 

Enrollment will be limited to 75 appli 
cants who will be selected on the basis of 
their present positions and responsibility for 
administration. Efforts will be made to 
select a representative group from nursing 
JANUARY 1967 




Queen Mother Elizabeth presents the 1966 Glaxo Scholarship to Sister Gene 
vieve of Dublin. This scholarship, administered by the British Commonwealth 
Nurses War Memorial Fund, will enable Sister Genevieve to study nursing 
education in Canada during the coming year. 



service administrators in hospitals, nursing 
service administrators in public health, nurs 
ing education administrators, and adminis 
trators and consultants in professional or 
ganizations. 

The course fee is $250 to include classes, 
study materials, lodging, and meals. Appli 
cation forms, which should be completed 
and returned to the School prior to March 
1, 1967, are available upon request. 

CNA Publishes Guide 

for Two-Year Diploma Programs 

A guide dealing with the development of 
two-year diploma programs in educational 
institutions has just been published by the 
Canadian Nurses Association. 

Approved for publication at the pre- 
convention executive meeting, it is designed 
for educators considering such programs, 
whether in a community college, junior 
college, vocational school or technical school. 

Called Guiding Principles for the Develop 
ment of Programs in Educational Institu 
tions Leading to a Diploma in Nursing, the 
document covers planning and investigation, 
organization and administration, faculty, 
students, curriculum and instruction, and 
physical facilities. 

The publication is available upon request 
from the CNA. Price $1.00. 



New Brunswick Nurses Take 
Important Step in Nursing 
Education 

The New Brunswick Association of Regis 
tered Nurses has asked the provincial 
government to take immediate steps to 
implement the plan for the education of 
nurses and health workers generally, as ad 
vocated in Portrait of Nursing by Dr. 
Katherine MacLaggan. 

The nurses request to government has 
been supported by citizens committees from 
all areas of the province chaired by Dr. 
Allan Sinclair of the University of New 
Brunswick law faculty. 

The proposals for the new system of edu 
cation concern a variety of health workers 
described as Nurse Grade I, Nurse Grade II, 
Wardkeeper and Ward Secretary. 

Both nursing groups would be prepared 
at the post high-school level within the 
province s general educational system. The 
Nurse Grade I would constitute 75 percent 
of the nursing complement and would be 
educated in a two-year period at new health 
institutes recommended for Saint John, 
Moncton, and Campbellton. Twenty-five per 
cent of the nurses, called Nurse Grade II, 
would be educated in New Brunswick s two 
established university schools of nursing. 
THE CANADIAN NURSE 7 



news 

The proposed health institutes would also 
educate the ward secretary and other per 
sonnel for the health field and would be 
administered by an independent council res 
ponsible to the minister of education. 

Envisioned under the program would be 
a phasing-out of existing schools of nursing 
over a period of years when newly-trained 
staff become available. It is estimated that 
from the start at any given time, a period 
of three years would be necessary for 
implementation. Existing health personnel 
trained under the present system would be 
retrained and protected on staff while new 
trainees would be trained under the propos 
ed new system. 

The plan suggests that the first pilot 
health institute be established in Saint John 
because of important community facilities, 
especially in an institute in close proximity 
to St. Joseph s and the Saint John General 
Hospitals. 

A Moncton institute on or near the Uni 
versity of Moncton campus which would 
provide easy access to hospitals, arts and 
science facilities is recommended. 

A third institute is invisioned in Camp- 
bellton to serve between 300-400 students 
at a cost of between one and two million 
dollars. 

The NBARN suggests that the capital cost 
of such institutes be born by the province 
which would be able to avail itself of health 
resources grants from the federal govern 
ment. 

The plan, which was published in 1965, 
has been endorsed by the Canadian Nurses 
Association. 

Alberta Nurses Serve in Africa 

Two instructors from the Foothills Hos 
pital school of nursing are in Geneva being 
briefed for World Health Organization as 
signments in West Africa. 

Margaret Svenningsen and Terry Knapik 
left Calgary New Year s Eve for WHO s 
headquarters at the Palais des Nations. 
Before taking up their two-year appointments 
in Ghana and Gambia they will stop over 
at Brazzaville in the Congo for further 
orientation. 

Miss Svenningsen will be teaching psy 
chiatric nursing at the University of Ghana. 
This is part of a two-year course for grad 
uate nurses. Her duties will include develop 
ing the mental health aspects of the cur 
riculum and also training a native African 
counterpart. 

Two hundred miles away, Miss Knapik 
will be teaching public health in the school 
of nursing at Bathurst. She will also train 
a native African counterpart and will be an 
advisor to the Minister of Public Health 
in Gambia. 

8 THE CANADIAN NURSE 




Nurses Recognized by Order of St. John. Three prominent members of 
the nursing profession pause for a photograph in the foyer of Government 
House in Ottawa after the Annual Investiture of the Order of St. John in 
November. They are, left to right: M. Pearl Stiver, former executive director 
of the Canadian Nurses Association; M. Christine Livingston former 
director-in-chief of the VON, and Margaret M. Hunter, chief nursing 
officer for St. John Ambulance in Canada. Miss Stiver and Miss Livingston, 
co-authors of St. John Ambulance s new Home Nursing textbook "Patient 
Care in the Home," which was released earlier this year, were honored 
with the rank of Commander Sister by the Order of St. John. 



Both nurses plan to remain with WHO 
following their tour of duty in West Africa. 

Home Care Topic for Institute 

Dalhousie University s school of nursing 
is sponsoring its 16th Annual Institute, 
February 8-10, 1967. 

The topic of the three-day workshop will 
be Co-Ordinated Home Care Programs. Mrs. 
Rosetta Lippe, assistant director of training 
and extended services in home care with 
New York s Montefiore Hospital, will be 
the conference leader. She will be assisted 
by members of the nursing and allied pro 
fessions in the Atlantic provinces. 

The aim of this year s institute is to 
enable all branches of nursing to fully un 
derstand Medicare s implications for home 
care. It will be held at the Victoria Gen 
eral Hospital Nurses Residence. Registration 
fee is $2.00. 

Medical Education 
Research Unit Established 

To find out what it takes to make a 
good doctor, the University of Toronto has 
established a medical education research 
unit the first in North America. 

The unit will include two medical doc 
tors, one of whom is a professor of psy 
chology and education, a data processing 
expert, and a statistician. They will seek 



answers to these questions: 

What are the qualities needed in a mo 
dern physician? 

What types of education, both general 
and specialized, will best prepare the doctor? 

What personal qualities are most likely 
to suit a student for the medical profes 
sion? 

The research team does not expect to have 
the answers for about 10 years. 

Newfoundland Seminar 
"One of the Best" 

The recent two-day workshop sponsored 
by the ARNN S committees on nursing edu 
cation and nursing service has been termed 
"one of the best." 

It is the second workshop held this year 
and according to ARNN President Janet 
Story "enthusiasm and attendance exceeded 
expectations." There were over 226 regis 
trants at the St. John s workshop and 100 
at the workshop in Gander. 

The seminar had as its theme "Analyzing 
Nursing Needs," with delegates discussing 
such topics as future planning to improve 
nursing care and team nursing. 

Consultant to the workshop was Mrs. 
Huguette Labelle, associate director of nurs 
ing education at the Ottawa General Hos 
pital. She addressed the delegates on the 
responsibilities of every team leader and 
emphasized the importance of such people 
in assuring good patient care. 

JANUARY 1967 



want to 

pay less 
income tax? 




Here s how smart Canadians are paying less 
income tax and building a retirement income to 
supplement their Canada Pension Plan. 



WHAT S AN ANNUITY? 

A Canadian Government 
Annuity is an investment 
you make to guarantee 
you a definite income 
when your working days 
are over. The premiums 
you pay may be deduct 
ible (within certain 
limits) for income tax 
purposes. This means that 
anybody can plan for an independent retire 
ment and cut income tax now. Those income 
tax savings will help you pay for your 
Annuity with very little financial strain. 

CHOOSE A PLAN 

TO SUIT YOUR NEEDS 

Whether you re just starting to work or 
ready to retire, you can choose a plan to 
suit your needs. It will depend upon your 




age, your future family and employment plans, 
the amount of income you want upon retiring. 

For instance, you can choose the Life Plan 
for a monthly income as long as you live. 
Or the Guaranteed Plan, also payable for 
life but in any event guaranteed for a 
definite number of years 5, 10, 15 or 20. 
Or the Contingent Survivor Plan which 
continues payments to your 
widow after your death. 
Your local Canadian 
Government Annuities 
Representative can help 
you decide which is the 
best plan for you. 

YOU CAN TAKE 
IT WITH YOU 

Your Canadian Government Annuity is fully 
portable. That means that if you change 
jobs, move, or go into business for yourself, 
there s no need to interrupt your payment 
pattern or alter your future plans. 




Perhaps you re already paying into a reg 
istered pension plan through your employer. 
If on termination of employment you are due 
to receive a lump sum payment, you would 
normally have to pay quite a bit of tax on 
that payment. But if you use the lump sum 
to buy a Canadian Government Annuity, 
registered as a Retirement 
Savings Plan, this sum 
would not be taxable. 

A SECURE SUPPLE 
MENT TO OTHER 
RETIREMENT INCOME 

Now is the time to plan 
for an adequate retirement 
income. Start now to build a supplement to 
the Canada Pension Plan benefits or income 
from other investments with a Canadian 
Government Annuity. Talk it over with the 
helpful Canadian Government Annuity 
Representative near you, or fill in and mail 
the coupon postage free. 




CANADA DEPARTMENT OF LABOUR, OTTAWA 
JANUARY 1967 




THE CANADIAN NURSE 9 



news 



(Continued from page 8) 

Canadian Welfare Council Says 
Action Needed to Increase 
Health Manpower 

The Canadian Welfare Council urges im 
mediate action to increase Canada s health 
manpower and improve the distribution and 
quality of personal health services during 
the period before the Medical Care Act is 
implemented. 



This is the gist of a resolution from the 
Council s Board of Governors, addressed to 
the federal government and circulated to 
provincial premiers and ministers of health 
and welfare. 

Commenting on the resolution, B. M. 
Alexander. Q.C., president of the Council 
said: "Like most members of parliament, 
including those in the government, we very 
much regret any postponement in the date 
of implementation. Apart from other con 
siderations, the connection between poverty 
and untreated ill health is all too obvious, 
and adequate health care measures are es 
sential to any realistic attack on poverty. 



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FLEET ENEMA s fast prep time obsoletes soap and 
water procedures. The enema does not require warm 
ing. It can be used at room temperature. It avoids the 
ordeal of injecting large quantities of fluid into the 
bowel, and the possibility of water intoxication. 
The patient should preferably be lying on the left side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. Left 
colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. If a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
And afterwards, no scrubbing, no sterilisation, no 
preparation for re-use. The complete FLEET ENEMA 
unit is simply discarded! 

Every special plastic "squeeze-bottle" contains 4!/ 2 
fl. oz. of precisely formulated solution, so that the 
adult dose of 4 fl. oz. can be easily expelled. A patented 
diaphragm prevents leakage and reverse flow, as well 
as ensuring a comfortable rate of administration. 
Eocn J 00 cc. of FLEET ENEMA contains: 

Sodium biphosphate 16 gm. 

Sodium phosphate 6 gm. 

For our brochure: "The Enema: Indications and Techniques", 
containing full information, write to: Professional Service 
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Montreal 3, P.O. 



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MONTREAL 

FOUNDED IN CANADA II 



10 THE CANADIAN NURSE 



Delay in improving health care is therefore 
most unfortunate, and we sincerely hope 
that it will be possible to advance the in 
troduction of medicare from July I, 1968. 
We are also very concerned that prepara 
tions for implementation - - and this, of 

course, means action by the provinces 

should not slow down in this interim 
period. It is all to easy to relax once the 
pressure of an urgent deadline is eased." 

On the question of health manpower and 
the distribution and quality of services, Mr. 
Alexander pointed out that although the 
Medical Care Act provides the major mecha 
nism for payment for medical care, strong 
concurrent action is needed on these other 
points if the program is to be truly ef 
fective. 

"The Royal Commission on Health Serv 
ices, while urging that initiation of a medi 
cal care program should not wait for an 
increase in health service resources, never 
theless strongly recommended a crash pro 
gram to strengthen them", Mr. Alexander 
said. "The Commission particularly referred 
to strengthening of health personnel, which 
is the first step in improving distribution and 
quality of services. We need to start now. 
through every means, public and private." 

Mr. Alexander stated that the Council s 
resolution was prepared by its recently es 
tablished Committee on the Health Aspects 
of Welfare, under the chairmanship of Dr. 
John E.F. Hastings of the University of 
Toronto School of Hygiene. 



Controversy Among Montreal s 
English-Speaking Nurses 

The English-speaking nurses of the Mon 
treal region have decided to undertake 
collective bargaining to regulate their work 
ing conditions. This change in attitude 
toward collective bargaining is partly because 
the Hospital Services Commission has tended 
to equalize salaries and working conditions 
throughout the province, and partly because 
the Association of Registered Nurses of the 
Province of Quebec has urged its members 
to use this means. 

At present two groups are competing to 
represent English-speaking nurses. The En 
glish-speaking chapter of District 1 1 held 
a meeting on December 5, 1966, at which 
the members adopted a resolution urging 
the nurses of the chapter to form an asso 
ciation to negotiate for working conditions. 
About 1,200 nurses were present at this 
meeting. During the following days, some 
5,000 nurses from the chapter were asked to 
vote in favor of the new Association and 
to sign a registration card. 

When this organizational procedure has 
been completed, the new association, which 
will most probably be called the United 
Nurses of Montreal, will immediately seek 
to become accredited as bargaining agent 
with the Labour Relations Board. 

(Continued on page 12) 
JANUARY 1967 



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news 



(Continued from page 10) 

The chapter president, Miss Moyra Allen 
told the press that the association will be 
independent of the large unions and will 
not resort to strike action. 

The Act regulating professional nursing 
in the Province of Quebec stipulates in Ar 
ticle 17 that "Each local association may 
negotiate, conclude and sign as agent . . . 
collective contracts or agreements with any 
category of employer." 

On the other hand, a group of nurses 
from the Jewish General Hospital, under 



the leadership of Miss Ruth Arnold, have 
already organized themselves, and have 
formed another organization known as the 
Metropolitan Association of Nurses. On 
November 24, 1966, this association asked 
for accreditation from the Labour Board 
and has begun recruiting nurses in other 
Montreal hospitals. 

At a meeting on December 8, 1966, this 
group declared that the chapter (through the 
United Nurses of Montreal) could not nego 
tiate for nurses as a large number of its 
members were nurses who held administra 
tive positions. Their lawyer, M. Marc La- 
pointe, also maintained that only the Metro 
politan Association of Nurses could obtain 
the necessary accreditation to represent the 
nurses. According to Miss Arnold, the 



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Two of our International Organizations work for you and 
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WHO 

World Health Organization 

FAO 

Food and Agriculture Organization 

Two of our International Organizations are concerned mainly 
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UN 

United Nations Organization 

UNESCO 

United Nations Educational, Scientific and Cultural 
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Would you like to know more about their work, their publica 
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Would you like to receive a catalogue of their reports on re 
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Write to : 

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12 THE CANADIAN NURSE 



district 11 Chapter should limit its actions 
to problems of a professional nature. 

It is premature to predict the outcome of 
these associations. The provincial association, 
the ANPQ, is not taking part in this debate; 
it is strictly a matter between the English- 
speaking chapter District 1 1 and the Metro 
politan Association of Nurses as autonomous 
organizations. 

Baccalaureate Awards in 68? 

Students aiming for baccalaureate degrees 
in nursing may be eligible for Canadian 
Nurses Foundation awards if Parliament 
approves a proposed change in the Founda 
tion s Letters Patent. 

At the CNF annual general meeting held 
Tuesday, December 6, 1966, at CNA House 
in Ottawa, it was proposed that the Founda 
tion awards, formerly available only to 
those enrolled in master s or doctoral degree 
programs, be extended to cover those seek 
ing baccalaureate degrees. 

A favorable vote carried the proposed 
amendment to the CNF Letters Patent. Un- 
anamously passed was a member s resolu 
tion that the awards selection committee 
give priority to students enrolled in master s 
and doctoral courses. 

Awards to baccalaureate students will not 
be available during the 1967-68 term since 
Parliamentary approval must be secured 
before the proposal can be implemented. 

Elected to serve on the new board during 
1967 and 1968 were M. Jean Anderson, 
Verna Huffman, Mrs. Eva T. McCutcheon 
and Alma Reid, and five members of the 
CNA Board of Directors: Dr. {Catherine 
MacLaggan, Mrs. Helen P. Glass, Phyllis J. 
Lyttle, E. Louise Miner, and Janet Story. 

These new board members will serve two- 
year terms as approved by constitutional 
amendment at the general meeting in 1965. 

Canadian Nurses at Expo 67 

Schools of nursing across Canada are 
cooperating with the Canadian Nurses Asso 
ciation in providing the nursing personnel 
necessary for its exhibit at Expo 67. 

Twenty-one graduate nurses and 78 stu 
dent nurses, on a rotating basis, will staff 
the ultra-modern "Nurses" Station for 
Intensive Observation" in the Man and 
his Health Pavilion. 

Equipped with telemetering and recording 
devices, television monitors and inter-com 
munication equipment, the station has been 
specially designed to show Expo s millions 
of visitors how nurses will be trained to 
maintain continuous observation of patients 
respiration rate, pulse, electrocardiograph 
pattern, and other parameters in providing 
intensive care. 

The graduate nurses will wear uniforms 
specially designed for the occasion with pins 
and caps of their respective schools. Student 
nurses will be in the distinctive uniforms of 
their schools. A roster of the participating 
schools and hospitals will be on one wall of 
the exhibit. 

JANUARY 1967 



news 



New Immigrants Protected 
Against Hospital Bills 

Newly-landed immigrants entering Ont 
ario without hospital insurance will in 
future be able to obtain temporary pro 
tection from Blue Cross until their govern 
ment hospital insurance takes over. 

Hospital insurance regulations in Ontario 
and most other Canadian provinces require 
new applicants to wait approximately three 
months before becoming eligible for bene 
fits. Until now. no alternative coverage has 
been available during this interim period, 
and the individual immigrant (or his sponsor) 
has been exposed to the possibility of heavy 
hospital bills. 

The new "Landed Immigrant" plan re 
cently announced by Ontario Blue Cross 
answers this threat by taking care of any 
hospital expenses up to a maximum of $30 
a day, the average daily hospital charge in 
Ontario. To obtain this coverage for a 
maximum period of 90 days (or until 
government hospital benefits become ef 
fective, whichever is sooner), the individual 
immigrant will pay to Blue Cross one 
premium of $14.94. The cost to a family, 
consisting of husband, wife and unmarried 
children up to age 21, will be $28.98. As 
the "Landed Immigrant" coverage cannot be 
continued beyond 90 days, it will still be ne 
cessary for an immigrant to apply for govern 
ment hospital insurance immediately upon 
arrival here to avoid a gap in protection. 

Although the 90-day hospital coverage is 
at present available only to persons immi 
grating to Ontario, Blue Cross Plans in other 
provinces have expressed interest in offering 
similar protection to their own immigrants. 

Immunity Test 

for German Measles 

A test for detecting immunity to rubella, 
commonly known as German measles, has 
been developed by scientists of the U. S. 
Public Health Service s National Institutes of 
Health. The test, called hemagglutination-in- 
hibition (H-I), was developed in the Division 
of Biologies Standards Laboratory of Viral 
Immunology of which Dr. Meyer is chief. 

The rubella H-I test employs the biolo 
gical principle of hemagglutination or red 
blood cell clumping, used successfully in 
studies on influenza and other diseases. Dr. 
Meyer and his co-workers found that special 
preparations of rubella virus cause the red 
blood cells of newly hatched chicks to 
clump. When they added a sample of 
blood from a person immune to German 
measles, the antibodies in the immune blood 
inhibited clumping. Thus, the inhibition of 
agglutination demonstrates the presence of 
antibody and immunity. 

The new test is so simple and reliable 
that a physician can determine within three 
JANUARY 1967 



Medical Care at Expo 67 



About 30,000 to 42,000 persons will 
require medical care during the six-month 
International Exhibition in Montreal this 
summer -- and Expo 67 officials will 
be ready for them. 

Medical aid at Expo will be provided 
in two main types of facility: first aid 
stations and medical aid clinics. As well, 
more than 1,500 personnel will be pre 
pared to administer emergency first aid 
treatment on the spot. 



Medical Aid Clinic- 




Four Medical 
Aid clinics will 
be set up, one 
in each sector 
Mackay Pier, 
He Sainte-Hele- 
ne, La Ronde. 
and He Notre- 
Dame. Each of 
these will be a 




10-bed hospital with facilities and staff 
to care for patients for up to 24 hours, 
if necessary. 

Negotiations are in progress to have 
the clinics serve as an extension facility 
of four of the larger Montreal hospitals. 
Patients requiring longer term hospitaliza- 
tion or more intensive care than the 10- 
bed facility can offer will be transferred 
to one of the larger institutions. 

Clinics will have two wards one of 
four beds, another of six kitchen, re 
ception, treatment and service rooms. 

First Aid Posts 

As well as the clinics, there will be 



two first aid posts in each sector. These 
will be open from 9:00 a.m. to 1:00 a.m. 
and will be staffed by St. John Ambu 
lance personnel. 

Many of the pavilions and exhibit 
areas are also planning first aid facilities. 
These will work 
closely with the 
Expo-sponsor 
ed services. 
Six ambulances 
will be provided 
for transport of 
patients on the 
Expo grounds 
and for taking 
patients to city hospitals. 

Forecasts 

Expo officials are expecting about 
270,000 people to visit the huge site 
each day. Based on statistics from the 
Brussels, New York, and ether major 
exhibitions, about 380 people will require 
treatment for first aid each day; 115-150 
will be referred to Medical Aid Clinics; 
and about 8 to 20 will require hospitali- 
zation. Facilities are expected to handle 
this number with relative ease. 

The most common disorders anticipated 
to require medical care at Expo are: 
minor cuts, falls, sprains, heat stroke, 
heart attacks, food poisoning, drownings, 
and maternity cases. 

In addition, Expo has worked closely 
with the Quebec Government Emergency 
Measures Organization to prepare a dis 
aster plan for the area. 



hours whether an expectant mother has anti 
bodies against the disease. It is also capable 
of detecting immunity years after infection. 

The major hazard of rubella virus lies 
in the risk of its transmission to the fetus 
during early pregnancy, resulting in such 
defects as blindness, deafness, congenital 
heart disease, and brain involvement result 
ing in mental retardation. 

Since the new immunity test is so inexpen 
sive and easy to perform, it is expected to 
become routinely available in hospitals, 
health departments, and other laboratories 
within the near future. 

Leukemia and Mongolism 
Investigated 

A paper prepared by the National Cancer 
Institute, National Institutes of Health, 
Bethesda, Maryland, examines the effects 
of maternal age and birth order on the risk 
of mongolism and leukemia. Authors 
Charles Stark and Nathan Mantel study 
children born in Michigan during 1950-64. 

They discovered a striking association 
between maternal age and mongolism, but 



found that birth order did not independently 
affect the risk of mongolism. On the other 
hand, both maternal age and birth order 
independently affected the risk of death 
from leukemia. 

Risk of death from leukemia decreased 
with advancing birth order and increased 
with advancing maternal age. Except for the 
older maternal age groups, these trends for 
leukemia are in contrast to the effects of 
maternal age and birth order on death due 
to all causes. This contrast suggests that 
maternal age and birth order may be closely 
associated with the etiological agents of 
childhood leukemia. 

Ontario Hospital Receives Grant 

National Health and Welfare Minister 
Allan J. MacEachen has announced that a 
federal grant of $281,938 for the Leaming 
ton District Memorial Hospital has been 
approved. The grant will assist construction 
and renovation programs for the hospital. 

A new addition will provide space for 

80 active treatment beds and 14 chronic 

care beds. (Continued on page 14) 

THE CANADIAN NURSE 13 



news 



(Continued from page 13) 

Renovations will improve patients rooms 
in the existing building. They will also pro 
vide for improving and expanding the kit 
chen, x-ray department, laboratories, deliv 
ery and operating rooms. 

The work is expected to be completed 
next month. 



Parents Enthusiastic 

About Hearing-Test Program 

A new program to detect hearing defects 
in newborn children has been launched at 
the Jewish General Hospital in Montreal. 

Dr. David Halperin, otolaryngologist-in- 
chief of the hospital, said the object of the 
program is to develop normal speech in the 
deaf child so that he may attend regular 
school classes by the time he reaches school 
age. "Until now, even though hearing loss 
in children could be detected at an early 
age, nothing could be done for them. This 
hearing loss resulted in development of 
speech defects," he said. 

Three different, small, portable machines, 
which have recently become available, can 
test hearing ability within days after birth. 
This breakthrough makes it possible to in 



stitute the corrective program at the hos 
pital. When deafness is detected in a child 
at birth, he can now be supplied with a 
hearing aid by the time he is six months old. 

Parents of newborn children at the Jewish 
General Hospital have responded enthusias 
tically to the project. Upon admission to 
hospital, the mother-to-be receives a bi 
lingual leaflet explaining the program. 

The leaflet says that "the incidence of 
hearing loss at birth is very small one out 
of a thousand newborns will have such a 
problem. If this one in a thousand is de 
tected within the first few weeks after birth, 
the development of speech defects will be 
avoided by taking immediate and appro 
priate training and educational measures." 

To test as many infants as possible, the 
hospital s clinic for communication disorders 
is working closely with its pediatric clinic 
and with the Herzl Health Service Centre. 
The cooperation of private pediatricians has 
also been obtained. 

The hearing testing program is twofold. 
Under the supervision of the hospital s au- 
diologist, Miss Sylvia Dubitsky, specially 
trained volunteers conduct tests either in 
the mother s room or in the nursery. After 
repeated testing to confirm the findings, 
any infant whose hearing is found to be 
impaired is sent to the McGill Project for 
Deaf Children for education and training. 
The McGill Project is under the direction of 



Daniel Ling, formerly principal of the Oral 
School for the Deaf and a leading authority 
in his field. The Project is staffed by teach 
ers specially trained for the work. 

The Royal Victoria and Queen Elizabeth 
Hospitals are both setting up hearing test 
ing programs similar to that now in opera 
tion at the Jewish General Hospital. 

"It is our ultimate aim to make it pos 
sible for every child with congenital hearing 
defects to attend a regular school at school 
entrance age," said Dr. Halperin. "There 
is no need, with all the facilities available, 
for any child to be isolated as a handicapped 
individual." 

Anti-Smoking Measures Continue 

A Smoking Withdrawal Study Center has 
opened in Toronto under the direction of 
Dr. N. Delarue of the University of Toron 
to and Dr. G. W. O. Moss, Deputy Medical 
Officer of Health for the City of Toronto. 

This experimental center hopes to deve 
lop new approaches to assist adults to stop 
smoking as well as to determine reasons for 
the successes or failures observed. 

One of the basic objectives of the Can 
adian Smoking and Health Program is to 
encourage smokers to discontinue the habit. 
Through health education it is also endea 
voring to dissuade non-smokers from acquir 
ing the habit. 



Facts about 
Registered Nurses 
in Canada 



age 



Source: Research Unit, 
Canadian Nurses 
Association, 1966 




35 - 44: 20.3 % 



45-54: 15.0% 



55 and over: 
10.5% 



Age not reported: 
7.9 % 



24 & under.- 12.7% 



25-34.- 33.7% 



14 THE CANADIAN NURSE 



JANUARY 1967 



news 



PMAC Head Urges Stronger 
Patent Laws 

The Pharmaceutical Manufacturers Asso 
ciation of Canada believes that stronger pat 
ent laws are needed to encourage pharmaceu 
tical production and research in Canada. 

Association president. Dr. Wm. W. Wigle, 
told the Commons Special Committee on 
Drug Costs and Prices recently that patents 
and the economic incentives they provide 
are essential to the discovery and continuing 
flow of health-restoring and life-saving phar- 
niaceuticals. 

Stressing the dangers inherent in any sug 
gestion that drug costs could be lowered by 
abolishing patents, Dr. Wigle said "from 
a therapeutic point of view it would be a 
medical catastrophe because research for 
new cures would be seriously arrested." He 
suggested that from an economic point of 
view it would destroy a growing industry 
and reduce it to nothing more than a collec 
tion of import houses and imitators. 

PMAC s patent advisor, Gordon Hender 
son, Q. C., pointed out to the committee 
that a patent not only encourages inven 
tion through research but constitutes an 
incentive to production. "The abolition of 
patents would lead to the Canadian market 
becoming dependent upon foreign producers 
with the risk that necessary drugs might be 
come unavailable in times of great need," he 
said. 

The association recommends that patent 
protection for drugs be strengthened by per 
mitting patents on drug products rather than 
just on manufacturing processes as at present. 

Manitoba Doctors Want 
Higher Pay 

Manitoba doctors have threatened to with 
draw from the province s doctor-operated 
medical insurance plan unless their demands 
for higher remuneration are met. 

The Manitoba Medical Service covers 
about 600,000 of the province s 1,000,000 
people. Doctors now receive payment on the 
basis of 80 percent of their operating fee 
schedule. They want 100 percent and threa 
ten to withdraw from the plan by July 1, 
1967, if they do not get it. 

At a special meeting of the Manitoba Me 
dical Association, some 200 doctors endorsed 
a resolution by president-elect, Dr. G. E. 
Mosher, asking that MMS achieve full pay 
ment of the fee schedule by mid- 1967. 

According to Dr. Mosher, the pro-rating 
principle was used when MMS was establi 
shed because it was needed to keep the ser 
vice solvent and the service was intended 
for low-income subscribers. "We cannot 
stand aside and idly watch economic factors 
wear away our standards until we are giving, 
and are receiving, assembly-line medicine." 

Dr. Mosher said that if the MMS failed 

JANUARY 1967 



to comply with the resolution, he would 
ask every doctor in Manitoba for a signed, 
undated letter, opting out of the plan. 

If the doctors demand is met, it could 
mean an increase in MMS subscriber fees of 
between 20 and 25 percent. 

Doctors say if they pull out of MMS, 
their services will still be available to their 
patients but on a direct basis. 

U.S. Study Reveals Shortage 
of Hospital Personnel 

A new study of health manpower sup 
ply and needs in United States hospitals 
reveals significant shortages in all categories 
of professional and technical personnel. 

The U.S. Department of Health, Educa 
tion and Welfare announced recently that 
comprehensive information on hospital man 
power is now available from a study made 
jointly by the American Hospital Associa 
tion and the Public Health Service. 

The study was made to determine the 
number of personnel employed, current 
vacancies, and estimates of personnel needs. 
Data from the first 4,600 hospitals which 
reported have been used to estimate totals 
for all 7,100 hospitals in the United States 
registered by the American Hospital Asso 
ciation. These reports indicate that the total 
number of professional, technical, and auxi 
liary personnel employed in hospitals is 
about 1.4 million. About 275,000 additional 
professional and technical personnel would 



In the Nightingale Tradition 




At a dinner party in Victoria, British 
Columbia, 40 members of the Victo 
ria Unit of the Nursing Sisters Asso 
ciation of Canada heard Mrs. G. 
Stewart, who was dressed to repre 
sent Florence Nightingale, read an 
address originally given by Miss 
Nightingale to her students at St. 
Thomas Hospital, England, in 1881. 
The theme of the evening was "Cen 
tennial," and many of those attend 
ing wore period costumes. 



be needed to provide optimum patient care, 
an increase of about 20 percent over present 
staffing. Over 80,000 more professional 
nurses and more than 40,000 practical 
nurses are needed. Some 50,000 aides are 
needed in general hospitals; another 30,000 
in psychiatric institutions. Over 9,000 more 
medical technologists, almost 7,000 social 
workers, and about 4,000 more physical 
therapists, x-ray technologists, and surgical 
technicians are needed. 

Most urgent needs are for nurses, practical 
nurses, and aides. High on the urgent list, 
too, are medical technologists, laboratory 
assistants, radiologic technologists, dietitians, 
physical therapists, occupational therapists, 
and social workers. 

Canadian-Designed Device 
Measures Hidden Skull Pressure ? 

A University of Saskatchewan biomedical 
engineering student has developed a device 
to measure intracranial pressure precisely. 
The instrument, created by Gerald Wade, 
was described at the Canadian Medical and 
Biological Engineering Conference in Otta 
wa. It may permit diagnosis of such serious 
conditions as hydrocephalus in infants be 
fore brain damage occurs. 

A fluid-filled transducer is placed against 
the fontanelle. The transducer feeds into 
an electronic recording device that gives a 
dial reading. The instrument makes 20 se 
parate determinations of the cerebrospinal 
fluid and provides a visual readout of the 
average fluid. 

The device is presently being used as a 
research instrument. Mr. Wade sees wide 
potential use for it in routine screening of 
newborn infants for the detection of ab 
normal intracranial pressures. 

Two-Day Conference Set on 
Rural Health 

Rural-urban Health Relationships will be 
the theme of the 20th National Conference 
on Rural Health to be held March 10-11, 
1967, at Charlotte, North Carolina. 

The conference will explore new needs and 
report on new developments in community 
planning and responsibility for health fa 
cilities and services; future patterns of per 
sonal health care; rural accident prevention 
and first aid instruction; and health man 
power planning and utilizing. 

There is no registration fee for the con 
ference, which will convene at 9:00 A.M., 
Friday, March 10. Registration opens at 
7:30 A.M.. March 10. 

Cooperating organizations include Co 
operative Extension Services, Farm Organi 
zations, Medical Associations and Auxilia 
ries, Health Departments, Allied Health Or 
ganizations, Women s Groups, Agricultural 
News Media, and Continuing Education 
Groups. 

Further details are available from the 
Council on Rural Health, American Medical 
Association, 535 North Dearborn Street, 
Chicago, Illinois, 60610. 

THE CANADIAN NURSE 15 



names 




With "no intention 
of reminiscing about 
past efforts, past fai 
lures, missed opportu 
nities, small accom 
plishments," Dorothy 
M. Percy retires, Jan 
uary 6, 1967, as chief 
nursing consultant for 
the Department of 
National Health and Welfare. 

Her many friends, admirers and colleagues 
who honored her at a testimonial dinner 
last September did not share her concepts 
of herself. 

She was recognized by Katherine Mac- 
Laggan, president of CNA, as "a woman 
who is an advisor on nursing, a consultant 
on nursing, a remarkable nurse, a pioneer, 
a success in the eyes of her peers and a 
recipient of love." 

Miss Percy, born and educated in Ottawa, 
began her nursing career in 1924 with her 
graduation from the Toronto General Hos 
pital School of Nursing. The following 
year she qualified in public health nursing at 
the University of Toronto. 

Before joining the Victorian Order of 
Nurses in 1927, Miss Percy served as head 
nurse in the medical ward of the Ottawa 
Civic Hospital. It was while she was in 
charge of publicity at national office that 
Miss Percy organized the VON s first mari 
onette show at the Toronto Exhibition. 

From 1934 to 1941 she was part of the 
teaching faculty of the University of Toron 
to. Immediately following her teaching 
career, Miss Percy enlisted with RMAC, and 
after a year at the Camp Borden Military 
Hospital, proceeded overseas to Canadian 
General Hospitals in Great Britain. She re 
turned to Canada in 1944 and was appointed 
matron at the Petawawa Military Hospital. 

Following the war, Dorothy Percy served 
as executive secretary of the Division of 
Health of the Welfare Council of Toronto. 
A year later, 1947, she was appointed to 
head the new division of nursing under the 
Department of National Health and Welfare. 

In 1953, Miss Percy was appointed chief 
nursing consultant to the Department of 
National Health and Welfare, in which ca 
pacity "she has been called upon to inter 
pret government policy and suggest the ap 
propriate ways and means of attaining objec 
tives." 

Plans for retirement? Miss Percy says, "1 
can t answer that at the moment. I m much 
too busy getting down to the dreary chore 
of cleaning out desk drawers and filing 
cabinets!" 

16 THE CANADIAN NURSE 




Mildred Irene Wal 
ker, senior nursing 
consultant in the occu 
pational health divi 
sion of the National 
Health and Welfare 
Department, retired 
November 30, 1966. 

Her busy and vari 
ed nursing career be 
gan in 1924 with her graduation from the 
Victoria Hospital School of Nursing, Lon 
don, Ontario. The following year, Miss 
Walker received her certificate in public 
health nursing from the University of West 
ern Ontario. 

Miss Walker s nursing career has been 
largely administrative. Following a short 
period of private duty nursing at Victoria 
Hospital, London, Ontario, she became a 
public health nurse in the town of Weston. 
Ontario. 

After two years she joined the staff of 
the Ontario department of health where she 
worked for three years. In 1930 Miss Walker 
joined the faculty of the University of West 
ern Ontario as a lecturer. She later became 
an assistant professor of nursing and served 
as chief of the division of study for gradu 
ate nurses in the Institute of Public Health 
at the University. 

Upon completion of her advanced study 
at Columbia University, New York, Miss 
Walker accepted the position of supervising 
nurse at Phillips Electrical Company, Brock- 
ville, Ontario. 

In 1949 Miss Walker became senior nurs 
ing consultant in the occupational health 
division of the Department of National 
Health and Welfare, Ottawa. In this posi 
tion she was responsible for developing the 
present industrial nursing program. 

On her retirement, November 30, 1966, 
Miss Walker was looking forward to "the 
first leisurely Christmas in years, and future 
enjoyment of a summer cottage on the St. 
Lawrence River." 

A new member has 
joined the editorial 

Staff Of THE CANADIAN 

NURSE. Carla Dianne 
Penn, born in London, 
England, received her 
education in Canada. 
She attended the Uni 
versity of Ottawa 
where she recently re 
ceived her B.A. (English). Miss Penn as 
sumed the position of editorial assistant 
in October. This is a new editorial position 
created to help meet the journal s expand 
ing needs. 





Cathryn Lillian Mar- 
tin, a native of Tex 
as, joined the staff of 
McMaster University 
School of Nursing in 
Hamilton, Ontario, 
this year. This is a first 
Canadian position for 
Miss Martin, who is a 
graduate of the School 
of Nursing of Tuskegee Institute, Alabama. 
She also holds a B.Sc.N. from the Institute 
and an M.A. in curriculum and teaching 
maternal-child health from Columbia Uni 
versity, New York. In 1965 she obtained 
her master of education with a major in 
guidance. 

Prior to her appointment as assistant profes 
sor of nursing at McMaster, Miss Martin 
held positions in various hospitals and 
schools of nursing in Texas, including her 
most recent as assistant professor at the 
Tuskegee Institute. 

A. Joyce Bailey re 
cently assumed the po 
sition of assistant di 
rector of nursing ser 
vice at The Wellesley 
Hospital, Toronto Ont 
ario. Miss Bailey, a 
1956 graduate of The 
Wellesley Hospital 
School of Nursing, re 
ceived her B.Sc.N. from the University of 
Toronto in 1964. The following year she 
was awarded the Canadian Nurses Founda 
tion Scholarship and is presently completing 
her thesis for Western Reserve University, 
Cleveland, Ohio. 

Prior to her present position as assistant 
director of nursing service, Miss Bailey 
worked at various levels on the staff of The 
Wellesley Hospital, including general staff 
nurse, assistant head nurse and head nurse. 

Rita J. Lussicr has 
been appointed nurs 
ing coordinator at the 
Expo 67 pavillion 
"Man and His Health." 
Miss Lussier gradu 
ated from the School 
of Nursing of the Mai- 
sonneuve Hospital and 
later obtained nursing 
experience in cardiac surgery at the Mon 
treal Children s Hospital. She received her 
baccalaureate in nursing science from 1 Insti- 
tut Marguerite d Youville in 1962. During 
the next three years, Miss Lussier taught at 
the School of Nursing at the Maisonneuve 

JANUARY 1967 





names 





Hospital, and in 1 965 was named assistant 
director of nursing service in charge of the 
inservice teaching program. 

Miss Lussier is on loan to Expo from the 
Maisonneuve Hospital. 

Lieutenant Colonel 
Muriel E. Everett, ad 
ministrator of the 
Salvation Army Grace 
General Hospital, St. 
St. James, Manitoba, 
recently received a fel 
lowship in the Amer 
ican College of Hos 
pital Administrators. 
Lieut. Colonel Everett, a native of Perth, 
Australia, served with the Australian Forces 
in the Far East as a nursing sister and held 
various appointments in her homeland be 
fore moving to Canada in 1951. She has 
held various positions in Canada, chiefly of 
an administrative nature, and has been ad 
ministrator of the Grace General since 1962. 

Another addition to 
the McMaster Univer 
sity School of Nursing 
staff is Gertrude Fran 
ces Burns. Miss Burns, 
a graduate of the 
Marymount School of 
Nursing, Sudbury Gen 
eral Hospital, Sudbury, 
Ontario, is a lecturer 
in medical-surgical nursing. 

After graduation Miss Burns worked as 
staff nurse on medical and surgical nursing 
wards at the Sudbury General Hospital. In 
1964 she went to McGill University in 
Montreal where she obtained a diploma in 
supervision and teaching and her bachelor s 
degree in nursing and nursing education. 

Between her university sessions and until 
her present appointment as lecturer. Miss 
Burns worked at The Montreal General 
Hospital. 

The new director of nursing at the Kirk- 
land and District Hospital, Kirkland Lake. 
Ontario is Annikki Huhtanen. 

Miss Huhtanen, a 1940 graduate of the 
School of Nursing in Viipuri, Finland, 
served in the Finninsh Army nursing service 
for four years following graduation. The 
next four years she worked as a staff nurse 
at the Central Military Hospital, Helsinki. 

Miss Huhtanen moved to Canada in 1949, 
and immediately began nursing at The 
Montreal General Hospital. After four years 
she moved to the Temiskaming Hospital, 
Temiskaming, Quebec, and in 1955 she 
moved again, this time to the Stevenson 
Memorial Hospital, Alliston, Ontario. 

In 1960 Miss Huhtanen returned to Fin 
land where she completed a course for di- 

JANUARY 1967 




rectors and administrators in the nursing 
field. Upon her return to Canada, she be 
came director of nursing, as well as super 
visor-administrator at the Cottage Hospital. 
Uxbridge. Ontario. 

Now in Kirkland Lake, Miss Huhtanen 
takes over supervisory duties from Miss 
Gertrude Koivu, who is now working to 
ward her nursing degree in Montreal. 

The new director of nursing spent two 
years in postgraduate study: one year in 
cero-bacteriology and one year in laboratory 
work in clinical hemotology. 

Her new duties include the charge of the 
nursing staff of 1 24 as well as responsibility 
for the staff of the central supply service 
and the operating room personnel. 

Grace Elizabeth Ter 
ry, a 1 963 graduate 
of the Victoria Hospi 
tal, London, Ontario, 
is a new lecturer in 
nursing at Hamilton s 
McMaster University. 
The past three years 
have been busy for 
Miss Terry. In 1 964 she received her 
B.Sc.N. in nursing education from the Uni 
versity of Western Ontario in London; 
throughout 1965 and 1966 she held positions 
as part-time lecturer in nursing at McMaster, 
general duty nurse at the Henderson Gen 
eral Hospital, Hamilton, and, finally, as 
sistant head nurse in the same hospital. 

Margaret G. Arnstein, well-known to 
Canadian nurses for her leadership in the 
profession, has retired from the U.S. Public 
Health Service to accept a professorship 
with the School of Public Health at the 
University of Michigan. 

As nurse director in the Service s Com 
missioned Corps, Miss Arnstein had been 
heading a nursing unit to serve health pro 
grams of the Agency for International 
Development, with special emphasis on the 
nurse and midwife role in the new programs 
of population control and nutrition. Her 
previous assignment was to the Rockefeller 
Foundation AID-Study of the preparation 
of health manpower in developing countries. 

From 1949 to 1964, Miss Arnstein direct 
ed programs that promoted the effective 
utilization and expansion of nursing service 
skills in all the States, that stimulated and 
supported the advancement of research in 
nursing, and that influenced the improve 
ment and growth of nursing education. She 
was instrumental in the development of both 
the U.S. Nurse Training Act of 1964 and 
the earlier legislation providing Federal 
traineeships to enable nurses to receive the 
educational preparation necessary for leader 
ship positions. 

A graduate of the Presbyterian Hospital 
School of Nursing, New York, Miss Arn 
stein earned her baccalaureate degree at 




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THE CANADIAN NURSE 17 



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names 



(Continued from [>ut>e 17) 

Smith College, her master of arts in public 
health nursing from Columbia University, 
and her master of public health from the 
Johns Hopkins School of Hygiene and 
Public Health. She holds honorary degrees 
of doctor of science from Smith College and 
Wayne State University. 

Arlene Elizabeth Aish, Catherine Shirley 
MacLeod, Hazel Lillian Salmon, Sally Jane 
Miller, and Judith Anne Ritchie have re 
cently joined the teaching staff of the School 
of Nursing, University of New Brunswick 
in Fredericton. 

Arlene Aish, a 1958 graduate of the School 
of Nursing, University of British Colum 
bia, worked as staff nurse at the Vancouver 
General Hospital and as public health nurse 
with the Toronto Department of Health 
before continuing her studies. In 1961 she 
obtained her master of nursing from the 
University of Washington, Seattle, and 
worked for the next four years as a lecturer 
at the University of Toronto School of 
Nursing. Miss Aish is presently an assistant 
professor at the School of Nursing, Uni 
versity of New Brunswick. 

Shirley MacLeod, a native of Denmark, 
Nova Scotia, received her training at the 
Moncton Hospital School of Nursing in 
1949. The following year she completed an 
obstetrical clinical course at the Margaret 
Hague Maternity Hospital in Jersey City, 
N.J. The next seven years Miss MacLeod 
spent as obstetrical supervisor at the Monc 
ton Hospital. Before taking up her new ap 
pointment as lecturer at the University of 
New Brunswick School of Nursing, Miss 
MacLeod received her baccalaureate degree 
from McGill University and was obstetrical 
clinical instructor at the Moncton Hospital 
School of Nursing. 

Hazel Salmon, a 1946 graduate of The 
Montreal General Hospital School of 
Nursing, has covered much territory in her 
nursing career. After receiving a certificate 
in public health nursing from McGill Uni 
versity, Miss Salmon spent three years as 
staff nurse with the New Brunswick Depart 
ment of Health. From 1952 to 1955 she 
served with the Victorian Order of Nurses 
in Woodstock, New Brunswick. Miss Salmon 
then headed north to work with the Indian 
and Northern Health Services in White- 
horse, Yukon, for two years as public 
health nurse and then went west to the 
Calgary area for two years in the same 
capacity. In 1962 she obtained her bachelor 
of nursing from Dalhousie University, N.S.. 
and in 1964 her master of (applied) science 
from McGill. Prior to her present appoint 
ment as lecturer at the School of Nursing, 



18 THE CANADIAN NURSE 



University of New Brunswick, Miss Salmon 
was supervisor of nursing with the Temis- 
kaming Health Unit, Kirkland Lake, Ont. 

Sally Jane Miller, from Edmundston, New 
Brunswick, graduated from the School of 
Nursing, University of New Brunswick in 
1964. Following graduation, she worked as 
general duty nurse at the Hotel-Dieu de 
Saint-Joseph in Edmundston. Her new po 
sition is clinical instructor at the University 
of New Brunswick School of Nursing. 

Judith Ritchie is another new clinical in 
structor at the U.N.B. School of Nursing. 
Miss Ritchie obtained her B.N. from the 
University of New Brunswick in 1965 and 
spent the following year as general duty 
nurse at the Montreal Children s Hospital. 

Margaret Harrison, Norma Jaenen, Edythe 
Huffman, Marie Knelsen, and Jessie Hibbert 

were recently appointed to the School of 
Nursing Faculty at the Calgary General 
Hospital. Returning to the Faculty after 
completion of studies are Coralea Toney, 
Elaine Parfirt, Barbara Dobbie and Judy Ban- 
natyne. 

Mrs. Harrison, a graduate in nursing 
science at the University of British Co 
lumbia, is teaching surgical nursing. 

Mrs. Jaenen, an instructor in orthopedic 
nursing, obtained her B.Sc.N. from the Uni 
versity of Saskatchewan. 

Mrs. Huffman, a former graduate of the 
School of Nursing, Calgary General Hos 
pital, served as senior health nurse in the 
Flin Flon, Manitoba Health Unit, and also 
worked with the Winnipeg Health Depart 
ment prior to her new position. She is pre 
sently instructor in obstetrical nursing. 

Mrs. Knelsen, another graduate of the 
School of Nursing, Calgary General Hospi 
tal, obtained a diploma in public health 
nursing from the University of Manitoba. 
She is assistant instructor in nursing arts and 
also teaches pharmacology. 

Mrs. Hibbert, a new instructor in psychi 
atric nursing, graduated from the Winnipeg 
General Hospital School of Nursing. She 
later attended the San Francisco State Col 
lege where she earned her B.A. in nursing 
and her M.A. in education. At UCLA Mrs. 
Hibbert obtained her Master s in psychiatric 
nursing. 

Miss Toney, a graduate of the Winnipeg 
General Hospital School of Nursing, has re 
turned to the Calgary General Hospital 
School of Nursing after completing her 
bachelor of nursing degree at McGill. She 
is instructor in gynecology. 

Mrs. Parfitt, who recently completed her 
B.Sc.N. at the University of Alberta is teach 
ing growth and development, ophthamology, 
and urology. 

Miss Dobbie, an instructor in pediatric 
nursing, obtained her bachelor of nursing 
degree from McGill University in Montreal. 

Mrs. Bannatyne, an instructor in medical 
nursing, recently earned her bachelor of 
science in nursing degree from the Uni 
versity of Alberta. 

JANUARY 1967 



names 



An Honorary Life Membership in the 
Nova Scotia Branch of The Canadian Public 
Health Association was awarded recently to 
Edna Pitts who retired from public health 
nursing in 1964. 

The award was made in recognition of 
her "diligent and conscientious approach to 
nursing care" and for her many years of 
devoted service to public health nursing 
in Nova Scotia. 

Miss Pitts busy nursing career began 
with her graduation from St. Mary s Hos 
pital, Brooklyn, New York. A course in 
public health nursing at Columbia Univer 
sity prepared her for the position of public 
health nurse with the Provincial Depart 
ment of Health in Cape Breton, where she 
worked for two years. In 1939 she was 
transferred to the staff of Lunenburg- 
Queens-Shelburne Division and, in 1955, to 
the Atlantic Health Unit, a position she 
held until her retirement in 1964. 

Miss Pitts will long be remembered for 
her "family centered" approach to nursing 
and for her keen interest in the affairs of 
the community in which she worked. 

Anita Germaine has been appointed director 
of nursing service at the Scarborough Cen- 
:enary Hospital, West Hill, Ontario. 

Miss Germaine is a graduate of the Gen- 
;ral Hospital School of Nursing, Pembroke, 
Ontario. Her experience includes nursing 
service, nursing education, and employment 
in various levels of management in a large 
;ransportation industry. 

On her return from England in 1960, 
she was assistant dean and consultant for 
an air career school, primarily interested in 
procedure, manuals and methods of per 
sonnel training for various transportation 
agencies in Canada and Africa. 

Miss Germaine joined the staff of Scar 
borough General Hospital in 1963 as an 
instructor in the registered nurse assistant 
school, and from 1964 to 1966 was asso- 
siate director of nursing service, coordinator 
of staff development and education pro 
grams, and responsible for management de 
velopment training within the hospital. 

Dianne J. Hoffinger and Alma M. Daisley 

were both awarded $1,000 bursaries from 
the Saskatchewan Registered Nurses Asso- 
siation. 

Miss Hoffinger, a native of Regina, Sas 
katchewan, is presently completing her 
nursing degree at the University of Al 
berta in Edmonton. 

Miss Daisley, a 1963 graduate of the Sas 
katoon City Hospital School of Nursing, is 
presently in her final year of the nursing 
program at the University of Western On 
tario, London. 

The SRNA bursary fund was established 

JANUARY 1967 



in 1 964 to provide financial assistance for 
registered nurses in postgraduate studies or 
in the final years of baccalaureate programs. 
The fund is financed from interest received 
from association investments and from dona 
tions and endowments. 

The 1 966 winner of the ARNN bursary 
is Donna Le Drew. The $150 bursary, offered 
by the Gander Chapter of the Association 
of Registered Nurses of Newfoundland, is 
to be offered annually to a student in the 
Gander area who has been accepted at one 
of the schools of nursing. Miss Le Drew 
commenced her nursing education at the 
General Hospital, St. John s, this October. 

Louise Dupuis, in her final year at the Uni 
versity of Ottawa School of Nursing, and 
Verna Jardine, at the University of New 
Brunswick School of Nursing, were both 
awarded the Muriel Archibald Scholarship. 
Valued at $500, this scholarship is presented 
by the New Brunswick Association of Regis 
tered Nurses. 

Carolyn Wilson and Annette Frenette have 
been awarded NBARN scholarships of $500 
each. Miss Wilson is presently attending the 
University of New Brunswick School of 
Nursing while Miss Frenette is continuing 
her studies at the University of Moncton 
School of Nursing. 

Ethel R, Irwin has been appointed senior 
consultant in public health nursing in the 
Local Health Services Branch, Toronto. For 
two years prior to taking up her new duties, 
Miss Irwin was regional consultant in public 
health nursing, London, Ontario. 

A graduate of the Toronto General Hos 
pital School of Nursing, Miss Irwin obtained 
her certificate in administration and super 
vision from the University of Toronto 
School of Nursing. In 1954 she joined the 
Temiskaming Health Unit and in 1956 was 
appointed regional supervisor in Northern 
Ontario. 

Mis Irwin returned to her studies in 1957 
as a student at Teachers College, Columbia 
University. She obtained her Bachelor of 
Science degree in 1961. 

Dr, Philip Banister has been appointed doc 
tor at the Child and Maternal Health Divi 
sion of the Department of Health and 
National Welfare. A specialist on pediatrics, 
Dr. Banister will help to complete the pub 
lication on standards of hospital care for 
mothers and their newborn infants. He will 
also be active in preparing the first national 
conference on maternal and infant hygiene, 
which will take place next year in Ottawa. 

Born in England, Dr. Banister received 
his medical degree from Edinbourgh Uni 
versity, Scotland. He specialized in pediatrics 
at the Montreal Children s Hospital as well 
as in the United States and Italy. D 



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A New Text! 
Kallins 

TEXTBOOK OF 

PUBLIC HEALTH NURSING 

Here is an effective new approach to public health 
nursing, stressing usable facts and principles of 
public health rather than theory. Designed for courses 
in Public Health Nursing, this new text integrates 
essential principles of the science of public health with 
the major areas of nursing knowledge and practice. 
Precise, readily understood discussions give students 
clear, effective guidelines and principles upon which 
to base their nursing diagnosis and intervention 
for the protection of health as well as prevention of 
disease and disability. You will find up-to-the-minute 
evaluations of current solutions to such new 
public health problems as mental health, drug 
addiction, alcoholism, air pollution control, poison 
and radiation control, housing and slum situations, 
rehabilitation, control of heart disease and cancer, 
as well as nursing education. TEXTBOOK OF 
PUBLIC HEALTH NURSING sheds new light on 
the growing dimension of this specialized area of 
nursing practice and gives the student nurse a 
thorough understanding of her potential role in the 
various public health areas. You will appreciate the 
flexible design of this new text, and its adaptability to 
your individual classroom situation. 

By ETHEL L. KALLINS, R.N., B.S., M.P.H., Assistant Professor 
of Public Health and Public Health Nursing, St. Joseph College, 
Division of Nursing, Emmitsburg, Maryland. Publication date: 
January, 1967. Approx. 375 pages, 6 l / 2 "x9y 2 ", 57 illustrations. 
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New 2nd Edit/on ! 
Heckel-Jordan 

PSYCHOLOGY 

The Nurse and the Patient 

The new 2nd edition of this stimulating textbc 
has been revised and updated to give the nursi 
a working knowledge of psychology so that si 
in turn, can deal more effectively with the mar 
of patients she encounters. This text can hel{ 
students clearly see the importance of psychol 
in achieving satisfactory nurse-patient relation 

Designed for basic courses in psychology in b( 
diploma and degree programs in Schools of 
Professional Nursing, this new 2nd edition has 
carefully revised to provide a completely cum 
in-depth presentation of general psychology a; 
relates to the field of nursing. Extremely read 
easy to understand, this new edition can help 1 
student relate psychological principles to her c 
experiences as a student, as a nurse and as a p< 
This edition examines its subject in greater de 
than the previous edition and includes all the 
views and concepts. An entirely new chapter 
on sensation can provide your students with a 
understanding of this subject. 

By ROBERT V. HECKEL, B.S., M.S., Ph.D., Professor of F 
Director of Clinical Training, and Director of the Psycholi 
Services Center, University of South Carolina, Columb 
and ROSE M. JORDAN, B.S., R.N., Supervision of In-Serv 
Education, Gracewood State School and Hospital, Gracew 
Publication date: January, 1967. 2nd edition, approx. 36 
61/2" x 91/2", 88 illustrations. Price, $8.10. 



20 THE CANADIAN NURSE 



JANUARY 1967 






New Book! 
:h-Wagner 

JRKBOOK FOR 
NECOLOGIC NURSING 

ynecologic disorders, many underlying 
hological factors are more disturbing to 
patient than the fact her physical health is 
tied. This new workbook assists the 
jnt nurse in becoming aware of this 
tional involvement and in learning how 
h explanation is within the scope of 
ing care. Giving close attention to both 

heory and clinical experiences involved in 

i cologic nursing, the authors specifically 
s the equal importance of student 

-wledge of reproductive anatomy and 
iology, and their awareness of the 

;nt s emotional involvement. 

seeding from the basic to the clinical, 
workbook explains the anatomy and 
iology of the female reproductive organs, 
describes puberty, the gynecologic 
aination and the nurse in the clinic, 
ders of menstruation, functional and 
unctional bleeding, and the menopause. 
>ng its timely discussions are those 
acterizing genital anomalies, gynecologic 
rtlems in marriage, pelvic inflammatory 
use, and neoplasms of the uterus 
ovaries. 

flexible design of this workbook makes it 
ly suited for use with any required text 
select. Perforated, punched pages 

v removal of completed assignments for 
ing and accumulation in a ring binder 
uture reference. Self-examination tests 
ncluded and a separate, 20 page answer 

*c is provided for the instructor. 

INSTANCE LERCH, R.N., B.S., (Ed.); and JOANNE 
U3NER, R.N., B.S. (Nurs.). Publication date: 
iry, 1967. Approx. 130 pages, 7^4" x 10y 2 ", 
rated, perforated and punched. About $3.80. 



HE C. V. MOSBY COMPANY, LTD. 

86 Northline Road Toronto 16, Ontario 



New 7th Edition ! 
Jessee 

SELF-TEACHING TESTS 
ARITHMETIC FOR NURSES 



Here is a simple, direct approach to basic arithmetic 
and its application to problems in dosages and solutions. 
Flexibly designed for use as either a self-teaching text 
or for classroom instruction, this book can help your 
student develop sufficient knowledge and skill in arithmetic 
so that she can learn to safely administer medications 
in the proper dosage. To bring it into closer conformity 
with modern mathematics, this new edition has been 
rewritten and expanded to incorporate new information 
and changes in terminology. 

This new edition has been designed with perforated, 
punched pages that can be easily removed from the text, 
handed in and/or kept in a separate book or folder. 
The achievement tests have been printed on separate pages 
so that, if desired, you can use them in evaluating the 
progress of your students. You will also appreciate 
the convenience of the separate answer book, provided 
with each copy at no additional cost. 

By RUTH W. JESSEE, R.N., Ed.D., Chairman, Department of Nursing 
Education, Wilkes College, Wilkes-Barre, Pennsylvania. Publication date: 
March, 1967. 7th edition, approx. 164 pages, 7Vi" x 10V 2 ", 
21 illustrations. About $3.25. 



New 4th Edition ! 
Price 

A HANDBOOK AND CHARTING 
MANUAL FOR STUDENT NURSES 

This unique handbook is ideally suited to ( 1 ) help the 
student applicant prepare herself to meet scholastic 
requirements for admission to schools of nursing and 
(2) to assist the beginning student who experiences 
difficulty with one or more of the courses she is taking. 
It is used as a self help handbook or as a required test. 
This book can help you give your students the additional 
help they may need in arithmetic, spelling, vocabulary, 
study habits and reading with comprehension, handwriting 
and printing, and personal appearance. An important 
feature of this workbook is the well written and highly 
understandable presentation of the fundamentals of 
charting. This section has been revised and updated 
in this edition to give the student the latest accepted 
methods and concepts of charting. 

By ALICE L. PRICE, R.N., M.A. Publication date: January, 1967. 
4th edition, approx. 220 pages, 8 l / 2 " x H". 50 illustrations. 
About $5.30. 



Publishers 




JANUARY 1967 



THE CANADIAN NURSE 21 



new products { 



Descriptions are based on information 
supplied by the manufacturer and are 
provided only as a service to readers. 



Benoxyl Lotion 

(WINLEY-MORRIS) 

Description A locally effective agent for 
the treatment of acne. Benoxyl lotion is a 
stable preparation of Benzoyl Peroxide 5% 
in a unique, greaseless, washable lotion base. 

Indications In the treatment of acne 
vulgaris as an antibacterial and mild kera- 
tolytic agent. 

Administration Cleanse skin with a mild 
soap such as Acne-Aid detergent soap. Ap 
ply Benoxyl Lotion to affected areas with 
fingertips and smooth in gently according 
to the following schedule: first 4 days: 
apply once daily, leave on for 2 hours, then 
remove with warm water; next 4 days: apply 
once daily, leave on for 4 hours, then re 
move; next three days: leave on overnight; 
ultimately: apply after each washing. 

Benoxyl is completely invisible on the 
skin. It should be stored in a cool dark 
place but not frozen. 

Caution Benoxyl is for external use 
only and should be kept away from eyes. 
mucous membranes and sensitive areas of 
the neck. Should excessive drying or irrita 
tion occur, use should be discontinued tem 
porarily. 

Disposable Toothbrush 

(VENDEX) 

Description An entirely new disposable 
toothbrush with its own bult-in dentifrice. 
Developed by Du Pont, this nylon bristle 
brush, to be distributed exclusively through 
vending machines, is intended to fill a 
serious gap in the dental hygiene routine of 
people who find themselves away from 
home without their regular toothbrush or 
toothpaste. 

Bristles are coated with a water-soluble 
dentifrice which is activated when moistened 
to perform the normal cleansing and breath- 
sweetening functions of ordinary dentifrices. 
Each brush is individually packaged in a 
cellophane wrapper and is so economical it 
may be thrown away after a single use. 

Vendex International, Inc., Houston, 
Texas, which has exclusive marketing rights 
on the new product, will distribute the 
brushes only through compact coin-operated 
vending machines located in selected wash 
rooms of clubs, restaurants, airports, mo 
tels . . . "wherever there are active people 
on the move." Vendex distributors are being 
established in each market to serve as local 
distributors for the handling of inventory 
and servicing of the machines. 

For additional information contact: Ro 
bert Fogle, vice president, Vendex Interna 
tional, Inc., 4125 Richmond Avenue, Hous 
ton, Texas. 
22 THE CANADIAN NURSE 




TRV3U.R INFANT VASCIJLAR CLAMP 



Infant Vascular Clamp 

(SKLAR) 

Use -- A new vascular clamp designed 
by Dr. G.A. Trusler of the University of 
Toronto. The new design has proven parti 
cularly useful in Blalock anastomisis, in the 
repair of infant coarctations, and in other 
procedures involving small vessels in chil 
dren and infants. 

Description 
The shaft is thin 
and springy, thus, 
when fully closed, 
the clamp will 
neither slip nor in 
jure the vessel. The 
"Z" shape of the 
jaws facilitates 
placing and tying 
of sutures. The op 
posing jaws of the 
clamp are relatively 
flat, with a finely 
roughened surface which provides a secure 
grip, but will not split the soft intimal lining 
of the vessel. 

Descriptive literature (No. 280-190) is 
available from J. Sklar Mfg. Co. Inc., 38-04 
Woodside Avenue, Long Island City, N.Y. 
11101. 

6 Pak Sutures 

(THOMPSON) 

Description Six non-absorbable sutures 
in one packet in a quick-opening "book." 
This package of sterile, non-traumatic silk 
sutures is convenient when a number of 
sutures are needed quickly by the surgeon. 
The six sutures, with attached needles, are 
threaded on a paper "book" having con 
venient end flaps. The folded book is sealed 
and irradiation sterilized in a transparent 
peelable outer envelope. The nurse or as 
sistant merely pulls the end flaps to open 
the book and the sutures are ready for 
instant use. 

R. B. Thompson Laboratories Ltd., an 
all-Canadian firm, developed this new "6 
Pak." Further information may be obtained 
by writing the Laboratories in Don Mills, 
Ontario. 

Acne Aid Cream 

(WINLEY-MORRIS) 

Description A flesh-colored, greaseless 
agent with water-washable base for the treat 
ment of acne. Acne-Aid cream is composed 
of 2.5% sulfur, 1.25% resorcinol, .625% 
hexachlorophene and .375% para meta 
chloroxylenol. 

Indications In acne vulgaris, and where 
a mild keratolytic, anti-seborrheic and anti 
microbial agent is required. 



Administration Wash the affected part 
with whatever special cleanser is recom 
mended by the doctor. Dry thoroughly 
without rubbing. Apply Acne-Aid Cream 
with the fingertips, allowing a thin film to 
remain. 

Caution Keep away from eyes and off 
eyelids. Should excessive dryness or irrita 
tion develop, discontinue use temporarily. 

Uroscreen Test 

(PFIZER) 

Description A simple, convenient, rapid 
and reliable screening test, standardized for 
the detection of significant bacteriuria 
(100,000 or more organisms per ml. of 
urine). Uroscreen is a white, dry, stable, 
soluble, buffered tetrazolium reagent (2, 3, 
5 triphenyl tetrazolium chloride). 

Indications The presence of significant 
bacteriuria is indicated by the formation of 
a pink to red precipitate indicating a pos 
itive uroscreen test. No precipitate or a 
colorless precipitate shows a negative uro 
screen test. 

Procedure - 1. Collect urine: early 
morning specimen is preferable. Collect the 
"midstream" specimen from men and the 
"clean-catch" specimen from women. !f the 
test cannot be performed within 2 hours 
after collection, the specimen should be 
stored, below 10C, up to 24 hours before 
uroscreen testing. 2. Add to uroscreen: Shake 
urine specimen until any precipitate is 
uniformly suspended. Add 2ml. of urine to 
the uroscreen tube, which is marked at the 
2 ml. level. Shake well until the uroscreen 
reagent is completely dissolved. 3. Incubate: 
Incubate at 37 C for 4 hours in the Uro 
screen dry-bath incubator or other suitable 
type. Important: do not shake or disturb the 
uroscreen tube during incubation. If the 
precipitate is disturbed before the reading, 
the resuspended precipitate must be centri- 
fuged or the test repeated. 4. Read results: A 
positive uroscreen test (pink to red precipi 
tate) is indicative of the presence of signifi 
cant bacteriuria and calls for detailed bac 
teriological examination of the urine. Highly 
infected urines may give a red precipitate 
within 1 or 2 hours and also show a red 
turbidity throughout the urine. A pink to 
red color, without precipitate, is negative; 
a precipitate of any other color is also 
negative. 

Uroscreen is presented in boxes of 50 
test tubes, ready to use. A special dry-bath 
incubator is available free of charge with 
initial orders of 100 tubes or more. 

For further information on Uroscreen and 
urinary tract infections, contact Pfizer Com 
pany Ltd., 50, Place Cremazie, Montreal 11. 
JANUARY 1967 



dates 



January 9-11, 1967 

Second Educational Assembly on 
Hospital Administration, District Eight, 
Fort Garry Hotel, Winnipeg. 

January 11-13 and January 16-18, 1967 

Institute for Supervisors, Ramada Inn, 
Vancouver, B.C. 
Open to all nurses working as 
supervisors or to head nurses who 
assume supervisory functions. 
Details may be obtained from the 
Registered Nurses Association of B.C. 

January 24-26, 1967 

Institute on Outpatient Department 
Nursing Service Management, 
Bellevue Stratford Hospital, 
Philadelphia, Penna. 

February 6-9, 1967 

Four-day conference on staff education 
and staff development. Sponsored by 
RNAO, OHA, OMA, OPHA, OHSC, 
Westbury Hotel, Toronto. 

February 19-23 

1 4th Annual Association of 
Operating Room Nurses Congress. 
El Cortez and U.S. Grant Hotels, 
San Diego, California. 
For information write 151 East 50th 
St., New York City or Miss Nellie 
Mock, 458 "F" St., Chula Vista, 
California. 

End of March 

Institutes for Instructors, Ramada Inn, 
Vancouver, B.C. 

A two-day institute sponsored by the 
Registered Nurses Association of B.C. 

April 28 - October 27, 1967 

Expo 67, Montreal. 

May 4-6, 1967 

St. Boniface Hospital, School of 
Nursing, 25th Reunion of the 1 942 
graduating class. Would members of 
the 1 942 graduating class please 
write to Miss F.E. Taylor, R.N., 
10123- 122 Street, Edmonton. 

May 8-12, 1967 

National League for Nursing, Biennial 
Convention, New York. 

May 10-12, 1967 

Canadian Hospital Association, 
Montreal, P.Q. 

May 16-19, 1967 

Alberta Association of Registered 
Nurses Annual Meeting, Chateau 
Lacombe, Edmonton, Alberta. 

JANUARY 1967 



May 24-26, 1967 

International symposium on electrical 
activity of the heart, London, Ontario. 
For further information, write to 
Dr. G.W. Manning, Victoria Hospital, 
London, Ont. 

May 31 - June 2, 1967 

Registered Nurses Association of 
Nova Scotia Annual Meeting, Sydney, 
N. S. 

May 31 - June 2, 1967 

Registered Nurses Association of 
British Columbia Annual Meeting, 
Bayshore Inn, Vancouver, B.C. 

June 12-15, 1967 

Canadian Dietetic Association 32nd 
Convention, Chateau Laurier, Ottawa. 

June 18-21, 1967 

Ottawa Civic Hospital, Centennial 

Home Coming. 

Alumnae or former associates of the 

Ottawa Civic Hospital who are 

interested in the Program should write 

to: Executive Director, Ottawa Civic 

Hospital. 

June 24, 1967 

St. Joseph s Hospital, Toronto, School 
of Nursing, Centennial Reunion. 
Any graduates who do not receive 
alumnae newsletters, please send 
name and address to: St. Joseph s 
Hospital, School of Nursing Alumnae, 
30 The Queensway, Toronto 3, 
Ontario. 

July, 1967 

75th Anniversary, Nova Scotia 

Hospital School of Nursing, Dartmouth, 

N.S. 

All interested graduates please 

contact Mrs. G. Varheff, 20 Ellenvale 

Ave., Dartmouth, N.S. 

July 31 - August 4, 1967 

The annual Medical Equipment 
Display and Conference (Medac 67). 
Sponsored by the Association for the 
advancement of medical instrumenta 
tion (AAMI), San Francisco Hilton 
Hotel. For information write : 
AAMI, P.O. Box 3 1 4, Harvard Square, 
Cambridge, Massachusetts 02 1 38. 

Sept. 15-17, 1967 

70th Anniversary, Aberdeen Hospital 
School of Nursing, New Glasgow, 
Nova Scotia. Those interested write-. 
Mrs. Allison MacCulloch, R.R. #2, 
New Glasgow, Pictou Co., 
Nova Scotia. 



MOVING 



DON T FORGET YOUR 
CHANGE OF ADDRESS 

Name: 
Registration No.: 

(If registered in two provinces, 
please give both.) 

Province: 
Old Address: 



New Address: 



Date effective: 



Allow at least six weeks 
for change of address 

Mail to: 

The Canadian Nurse 

50 the Driveway 
Ottawa 4, Ont. 



THE CANADIAN NURSE 23 



No one ever said it would be easy. 



. . . running a hospital with a minimum of 
medical supplies - building a bridge with 
nothing but timber and sweat - teaching a 
child who knows only a strange tongue. But 
that s what CUSO workers do ... hundreds 
of them in 35 countries. They meet the chal 
lenge of a world of inequalities - in educa 
tion, in technical facilities, in engineering 
and medicine. 

This year, the Canadian University Service 
Overseas - a non-profit non-government 
organization - has already sent 350 young 
volunteers to countries in Asia, in Africa, 
South America and the Caribbean ... a 
total of 550 CUSO people altogether in 
the field, or about 1 to every 50,000 
people who ask for their help. More 
are needed. 
The pay is low . . . you won t make a 




profit. Unless you count it profitable to see 
developing nations master new skills and 
new standards of health and science. 
You can t earn a promotion . . . but you can 
promote. You vvijj promote new learning, and 
enthusiasm, and a desire to succeed in 
people who are eager to help themselves. 
There are no Christmas bonuses . . . but you 
earn a bonus every day in the response of 
the people you work and live with. And you ll 
be amazed at how quickly you ll find an op 
portunity to develop your ideas, your dreams. 
Willing to work to build a better world? 
Here s just the job for you. 
How do you apply? Get more informa 
tion and application forms from local 
CUSO representatives at any Canadian 
university, or from the Executive Sec 
retary of CUSO. 151 Slater St., Ottawa. 



CUSO 

The Canadian Peace Corps 



24 THE CANADIAN NURSE 



JANUARY 1967 



EDITORIAL 



"Wanted a revised Income Tax Act 
that recognizes the role of married 
women in the labor force." 

This is what over one million work 
ing women -- and their husbands - 
will yearn for when they compile their 
annual income tax forms early in 1967. 
For the present income tax structure 
is geared to a Victorian society where 
only the man of the family was employ 
ed and the woman stayed home as a 
dependent. 

Husband no longer sole breadwinner 

According to 1965 data from the 
Special Surveys Division, Dominion 
Bureau of Statistics, the number of 
working women in this country is now 
over 2 million. This represents 30 
percent of the total work force. 

Prior to 1960, single women out 
ranked married women in the labor 
force. Since 1960, however, married 
women have maintained first rank in 
the percentage distribution by marital 
status. Their percentage passed the 
half-way mark in 1964, and now stands 
at 52.2. 

That these married women play an 
essential role in our economy is un 
deniable. That the large number of 
married women who are presently un 
employed would be valuable recruits 
to the labor force is also undeniable, 
except by those few who still maintain 
that the woman s place belongs only 
at the hearth. 

Needed changes in tax structure 

The major changes that are needed 
to bring income tax regulations up-to- 
date with the manpower structure in 
Canada were brought to the attention 
of the House of Commons this past 
June, by Mrs. Grace Maclnnis, Mem 
ber of Parliament for Vancouver- 
Kingsway, B.C. 

Mrs. Maclnnis said that the amount 
a married woman is allowed to earn 
before deductions are made from her 
husband s taxable income ($250), is 
far too low, considering today s cost 
of living. She pointed out that various 
organizations across the country have 
JANUARY 1967 



requested that it be raised. The Can 
adian Federation of University Women, 
for example, have urged that the 
amount be increased to $950. 

The second change in taxation 
policy proposed by Mrs. Maclnnis, in 
volved the expenses of housekeeping 
and babysitting services. She recom 
mended that the wages of housekeepers 
should be deductible from the taxable 
incomes of mothers working outside 
the home. In defence of her proposal 
she said: 

"It is no use telling us that it is 
all very well for lawyers and business 
men to deduct necessary expenses, but 
that it is quite another matter for a 
woman working outside the home to 
ask for the right to make the same 
sort of deductions. The expenditure is 
just as necessary. In fact, it is more 
necessary because it has been esta 
blished . . . that the vast majority of 
women who go to work ... do so from 
economic necessity, and there is no 
question of their being able to meet 
the costs of a housekeeper from out 
side earnings." 

In an earlier speech in the House of 
Commons, Mrs. Maclnnis questioned 
the incongruity of a law that calls a 
working woman who employs a house 
keeper an "employer" - and requires 
her to contribute to the housekeeper s 
Canada Pension Plan yet refuses to 
call her an employer under the Income 
Tax Act, thereby disallowing any de 
ductions of housekeeper expenses. 

Taxation in other countries 

In certain countries, such as the 
United States of America and the 
United Kingdom, the tax position for 
married women is quite favorable. 

In the United States, for example, a 
working wife can deduct up to $900 
for child care expenses when there are 
two or more children, or $600 for one 
child. The stipulations are that the 
child be no more than 12 vears old, 
and that the joint income of the parents 
not exceed $6,000. 

In the United Kingdom, preference 
is given to working married women: 
they get a single person s tax-free al 



lowance for earnings, in addition to 
the husband benefiting from the mar 
ried man s allowance, which is nearly 
double the single person s.* 

The tax structures in a few coun 
tries, on the other hand, appear to be 
intended to discourage the wives of 
all but the neediest of husbands from 
employment. In the Netherlands, for 
example, a married woman s earnings 
are taxed 15 percent if she is not the 
breadwinner.** 

Nurses effected 

What effect does this out-dated in 
come tax act have on nurses? 

For single nurses, it has little effect 
at this time; however, a few years from 
now many of these nurses will have 
assumed the role of wife, and possibly, 
mother. If the present trend toward 
employment continues and there is 
every reason to believe it will -- they 
will be among those affected by these 
discriminatory tax policies. 

For married nurses, who represent 
60 percent of all nurses employed full- 
time, these tax policies must be frus 
trating, costly, and discouraging. That 
these nurses continue to work in spite 
of them is proof of their desire to 
remain active in the profession. 

For the 19,781 married nurses listed 
as "not employed in nursing" in 1965, 
the present income tax policies un 
doubtedly discourage re-employment. 
The return of even a portion of these 
women to active nursing would do 
much to offset the critical shortage of 
nurses throughout the country. 

Conclusion 

For those married nurses already 
working, and for those who represent 
a large, untapped source of manpower, 
revisions of the Income Tax Act would 
mean one less obstacle in the path to 
employment. 

If we speak loudly enough, in 
unison, Canada will listen. 

* Viola Klein, Women Workers Working 
Hours and Services, Paris, Organization for 
Economic Co-operation and Development, 
1965. 
** Ibid. 

THE CANADIAN NURSE 25 



Habilitation of thalidomide 
children: the nursing approach 



How do thalidomide children react to the outside world after a prolonged 
hospitalization and what type of help do they need to adjust to it? A team at the 
Rehabilitation Institute of Montreal attempted to answer these questions. 



Mary O Brien, R.N., Margaret Owens, R.N., and Jan Ralph, R.N. 



Most of the children suffering from 
congenital deformities as a result of 
thalidomide were hospitalized during 
their first year of life. At this stage, 
the nurse s role was largely custodial. 
The nursing problems of these chil 
dren skin care, sitting balance, and 
protection from injury differed from 
those of normal children. 

As the children started to grow, 
however, the nurse had to re-examine 
her role. How could the basic concept 
of rehabilitation - - the return of the 
patient to a meaningful role in society 
- be applied to these children who 
had little or no idea of the outside 
world? 

Several of these children were still 
hospitalized at two years of age. The 
difference in development between 
them and the children who had the 
advantages of normal home life was 
apparent. It was pinpointed by the 
work of our colleagues in psychology, 
whose findings made it evident that 
something had to be done to provide 
the hospitalized children with some 
of the advantages and stimulation of 
a domestic environment. 

The first problem involved the num 
ber of persons coming in contact with 
the children. A study by the hospital s 
social service department showed that 
each child had a minimum of 43 con 
tacts each day: nurses, doctors, thera 
pists, volunteers, nonprofessional staff, 
patients, and visitors. Further, because 
of the rotation system, the nurses car 
ing for the children changed two or 

26 THE CANADIAN NURSE 



three times each week. 

Several steps were taken to solve 
these problems. First, a "baby-team," 
consisting of two registered nurses and 
one licensed nursing assistant, was set 
up. The team leader was a nurse with 
pediatric training and a great deal of 
experience. The second R.N. was the 
mother of a two-year-old. The nursing 
assistant was a young married woman 
who had shown special aptitude in 
caring for children. Two nursing as 
sistants were assigned especially for 
evening duty. 

This team, under the supervision of 
the head nurse, took over the complete 
care of the children. The arrangement 
demanded some sacrifice from the 
other staff in the unit. Since the baby 
team did not rotate, the other staff 
had to do more tours on shift duty; 
also, those not assigned to care for the 
children regretted the loss of contact 
with a most lovable group of patients. 
However, after an explanation by the 
director of nursing, they accepted these 
arrangements. Similarly, the volunteers 
cheerfully agreed to confine their at 
tentions to the older children. 

The head nurse then re-examined 
the physical setup of the ward. In 
stead of occupying six small rooms - 
four for sleeping, one for eating, and 

Miss O Brien was director of nursing at 
the Rehabilitation Institute of Montreal. 
Miss Owens is head nurse on the pediatric 
unit, and Miss Ralph is the team leader 
of the "baby team" formed at the Institute. 



one for playing - - the children took 
over two large units one for sleep 
ing, the other for eating and playing. 

This had many advantages: 1 . The 
children seemed more secure and less 
confined within a larger, definite area. 
They were out of the way of other 
patients, wheelchairs and corridor traf 
fic; 2. The rooms (23 feet x 17 1/2 
feet) were near the nursing station, so 
that observation was constant; 3. Bet 
ter cross-ventilation was possible and 
it was easier to maintain a constant 
room temperature; 4. The children s 
toys and equipment were more ade 
quately controlled and were safe from 
the raids of older children. 

At this point, the baby team dis 
carded their uniforms in favor of street 
clothing. This proved very successful. 
The children were encouraged to call 
the baby team nurses by their Christian 
names. There were two reasons for 
this. The children s speech develop 
ment was slow and it did not seem 
reasonable to expect a child whose 
first words would normally be "mama" 
or "papa", to substitute "Miss Ralph" 
or "Madame Roussel." Further, at two 
to three years of age, the children were 
not identifying individuals. As they 
were mostly French-speaking, everyone 
was "ma tante." By using Christian 
names, the children found it easier to 
identify the nurses, and their "aunts" 
became special rather than general. 

The next step was to introduce the 
children to the outside world. Outings 
were initiated at such times as they 

JANUARY 1967 




The clothing requirements of children 
with deformities are complex. The staff 
at the Rehabilitation Institute of 
Montreal developed several functional 
garments for the children with 
prostheses, including the dress and 
panties shown in photograph. 



JANUARY 1967 



could be coordinated with prosthetic 
training. Small groups were taken to 
visit the zoo, the circus, shopping cen 
ters, Santa Claus, and to eat lunch 
in a restaurant. They had picnics and 
train rides and were taken skating in 
a public park. When the children were 
from three-and-one-half to four-years- 
old, our physiotherapy department 
began teaching them to swim; their 
daily sessions in the pool are now a 
high spot. 

The baby team nurses also took the 
children to their own homes for lunch. 
On these visits the children appreciated 
seeing things they did not see in the 
Institute: design and color of food; 
china and tablecloths; shower curtains; 
door knobs, and carpets. We have tried 
to introduce as many of these as pos 
sible to the Institute. 

The result of these outings was ex 
tremely satisfying. The most with 
drawn child became quite relaxed 
about new human contacts. The reac 
tion of the general public was also 
encouraging. Apart from an occasional 
stare and a few questions from mothers 
with children of the same age, we met 
only kindly interest and offers of help. 

From the outings the children de 
veloped interest in dressing and wear 
ing pretty clothes. We made no attempt 
to hide prostheses, but tried to dress 
the children as much as possible like 
children their own age. They now 
have very definite likes and dislikes in 
color, and we have tried to make them 
feel that the garments they prefer are 
THE CANADIAN NURSE 27 



The hospitalized children now occupy 
two large units one for sleeping, 
the other for eating and playing. 



Daily swimming sessions in the pool 
are a high spot for the children. 





their own and not communal. 

The clothing requirements of chil 
dren with deformities are complex. As 
so many people are involved, the baby 
team leader has been given the addi 
tional assignment of coordinating the 
needs and ideas of occupational thera 
pist, parents, nurses and volunteers. 

Much thought was given to the de 
sign of garments to be worn over pros- 
theses, especially those of the upper 
extremities. After consultation with 
nurses, occupational therapists, psy 
chologists, and a group of ladies who 
kindly offered to sew for us, we have 
evolved several functional garments 
that are also attractive. Velcro clos 
ures have been used instead of but 
tons, but the illusion has been pre 
served by sewing buttons in place. 
Since we found that the action of 
cables quickly wore through materials, 
we have used iron-on patches inside 
shirts and in dresses across the shoul 
ders. The velcro can be opened and 
closed with the prosthesis or feet, thus 
making the child as independent as 
possible in dressing and undressing. 

One attractive but useful dress has 
velcro closures down the back. It is 
sleeveless with separate sleeves (in a 
white or contrasting color) which can 
be attached with velcro inside around 
the armhole. For most activities the 
child can use the prosthesis without 
sleeves; for dress-up occasions the 
sleeves are easily attached. 

Toilet independence has presented 
many problems because of the chil- 

28 THE CANADIAN NURSE 



dren s prostheses and lack of upper 
extremities. Panties have been designed 
on a diaper principle, with strips of 
velcro down each side substituting for 
safety pins. The diaper is held around 
the waist by an attached band of ma 
terial. To remove the flap of the pan 
ties for toilet purposes, the front flap 
can be pulled down with the child s 
prosthesis or fingers inserted in a loop 
made of tape on either upper front 
corner of the diaper. To replace the 
flap of the panties, the child sits down 
on the diaper and raises the flap using 
the loops to pull it up into position. 
Then he stands up and presses his hips 
against the wall to fasten the velcro 
securely. One of our mothers devised 
a method of pulling panties up and 
down with tapes and attaching them 
with velcro, but this method still re 
quires further thought and develop 
ment. 

It is interesting to note how the 
concept of the "rehabilitation team" is 
applied to the thalidomide group of 
children. Every week the baby team 
has held a meeting led by the con 
sultant in psychology. Her advice on 
the management of individual children 
and general problems has been inval 
uable. Since the nurse and occupational 
therapist must work together in pros 
thetic training, the occupational thera 
pist in charge of the children also at 
tended these meetings. From the meet 
ings a most rewarding relationship 
with social service developed, which 
has since expanded beyond this group 



of children to all age groups in the 
unit. Our colleagues in speech therapy 
who attended these meetings outlined 
the normal development of speech and 
pointed out specific difficulties with 
various children. The department of 
therapeutic recreation helped us with 
outings. Volunteers have been very 
valuable. In fact, the whole operation 
has been a real team effort, under 
the benign supervision of the chief of 
service. 

Now the children are all in their 
own homes or foster homes. We hope 
that we have made their adjustment a 
little easier. Certainly congenitally mal 
formed children who come to us in 
future will present fewer problems to 
the nursing department in the light 
of this unique experience. D 



JANUARY 1967 



Impact of cerebral palsy on 
patient and family 

Feelings of inferiority on the part of the patient, jealousy on the part of the 
siblings, and guilt on the part of parents, are common reactions to this disease. 



William A. Hawke, M.D., F.R.C.P. (Lond.) , F.R.C.P. (C) 



What must parents face when told 
that their child has cerebral palsy? 
They must face the fact that the con 
dition cannot be cured by medical or 
surgical procedures and that the effects 
of the disease will persist throughout 
the life of the individual. They must 
realize that the disease may limit 
education and employability, marriage 
and the bearing of children, self- 
sufficiency, and self-support. Although 
these limitations are modifiable through 
therapy, the parents will have to invest 
a considerable amount of time and 
money in the therapeutic program. 
This program will change the normal 
routines of the home and will, of 
necessity, create an extremely close 
relationship between the parents and 
their handicapped child. 

Some parents will have to face the 
fact that their child has additional de 
fects, such as mental retardation, deaf 
ness, aphasia, and convulsions, with 
all their inherent problems. 

The impact of the diagnosis on the 
family is tremendous, and the inter 
view during which the parents are 
confronted with this diagnosis is ex 
tremely traumatic. 

Problems unique to cerebral palsy 

The diagnosis of cerebral palsy is 
usually made after months of anxiety. 
Frequently, the parents have been dis 
turbed by a number of different and 
conflicting diagnoses including, in most 
cases, that of mental retardation. This 
delay is less frequent in recent years, 
JANUARY 1967 



however, since physicians are becom 
ing more skilled in diagnosing cerebral 
palsy in young children, and are be 
coming more cautious in diagnosing 
mental retardation. 

The parents of cerebral palsied 
children affect each other both indi 
vidually and in groups. These relation 
ships are usually beneficial. Parents 
provide each other with additional 
information about the disease and 
about techniques that they have found 
to be effective. In many instances they 
support each other. On occasion, 
however, the effects may not be so 
satisfactory. Some parents make others, 
who plan to place their severely handi 
capped children in institutions, feel 
that they are inadequate parents who 
are shirking their responsibilities. Oc 
casionally, certain parents may make 
it difficult for other parents to accept 
the reality of the situation, the limita 
tions of therapy, and the ultimate 
future. These effects, however, seem 
to be less frequent at the present time, 
probably because families have a 
closer relationship with treatment cen 
ters, particularly with social workers 
in these centers. 

The staff of the treatment centers 
may create problems for the parents. 
Occasionally they give a poor prog 
nosis, which is unwarranted. More 

Dr. Hawke is Professor of Pediatrics, 
University of Toronto, and Director of the 
Neurological and Psychiatric Services of 
The Hospital for Sick Children, Toronto. 



frequently, however, they create opti 
mism in the parents because of an un 
justifiably euphoric prognosis. 

There are several reasons for this 
over optimism. First, staff members are 
sympathetic to the parents and do not 
wish to make them face unpleasant 
realities. Second, certain members of 
the staff may lack experience and 
have not followed the progress of such 
children for sufficient time to learn 
the natural course of the disease. In 
most cases, however, the staff and fam 
ily become involved in a personal 
struggle against the disease, and in 
this struggle the staff member loses 
his or her objectivity. Fortunately, 
these effects are less prominent at pres 
ent because most clinics now have 
conferences in which the child s his 
tory is presented to the staff for dis 
cussion. 

These are only a few of the prob 
lems that may be considered specific 
to cerebral palsy. They are, however, 
the most frequently occurring prob 
lems. 

Effect on parents 

Feelings of anxiety may develop in 
the parents, particularly if the disease 
is severe and the prognosis grave. In 
one extreme case of anxiety reported 
several years ago, two elderly per 
sons killed their only son who had 
cerebral palsy, since they felt that they 
no longer could give him adequate 
care. They killed him rather than let 
him go to an institution where they 

THE CANADIAN NURSE 29 



believed he would be given inadequate 
and impersonal care. 

A feeling of anger is also a com 
mon reaction of parents. In most 
cases the anger is originally directed 
against fate. "Why did this have to 
happen to me and my child?" It is 
seldom directed against the child, but 
is projected on other individuals. 
Parents may project this free-floating 
anger toward the physician, blaming 
him because they believe the disease 
was due to improper delivery or to 
inadequate care during pregnancy be 
cause the condition was originally mis- 
diagnosed. They may project this 
anger toward the physician because he 
is unable to cure the disease. This 
hostility is sometimes directed against 
neighbors, or even strangers on the 
street. Curiosity on the part of such 
individuals may be considered by the 
parents as evidence that they regard 
the child as a freak. 

Feelings of guilt frequently are 
evidenced by parents. If there has been 
a similar condition in the family, they 
feel responsible for transmission of the 
disease. They may feel responsible 
for the child s cerebral palsy for a 
number of reasons: Mothers who have 
not followed the prescribed regimen 
during pregnancy may believe that 
their negligence is responsible for the 
condition. In a certain number of 
cases, the pregnancy was unwanted, 
and the mothers carried out a number 
of simple activities, such as long walks, 
hot and cold baths, etc., in the hope 
that these would produce an abortion. 
If the child is born with a defect, the 
parents feel that these attempts at 
abortion have been responsible for the 
defect. Other parents of a handicapped 
child may feel that this has been their 
punishment for past misdemeanors, 
often sexual in nature. 

Feelings of denial may be part of 
the parents pattern of defence. It is 
very difficult for parents to deny the 
cerebral palsy, but many deny the 
prognosis, accepting the realities of the 
present disability, but not of the future. 
These parents frequently travel from 
clinic to clinic, hoping to find someone 
who will justify their opinions. 

30 THE CANADIAN NURSE 



Feelings of rejection may occur be 
cause of the unusual appearance of the 
child, because of the additional burden 
imposed on the family, and, in some 
cases, because the individual is unable 
to accept the fact that a child of his 
can be incomplete or inadequate. Open 
and frank rejection of the child is 
uncommon. Such feelings are usually 
intolerable to the parents and are re 
placed by feelings of oversolicitude and 
overprotection. 

Not all overprotection is a compen 
sation for rejection. It may simply be 
the reaction of very affectionate 
parents who feel sorry for their 
handicapped child. An extreme exam 
ple of overprotection was the mother 
of the epileptic child who would not 
allow her daughter to cross the road 
for fear that she might have a seizure. 
This mother went to school with the 
child, returned with her, and stood 
at the window in her home during the 
rest of the day to see that she was 
not on the road. The mother of a 14- 
year-old diabetic boy who had noc 
turnal reactions, slept with him so 
that she could detect any reactions 
that developed. 

Effect on siblings 

Usually the brothers and sisters of 
the cerebral palsied child feel pity for 
him, particularly if he is younger. They 
feel sorry for him because his activities 
are so restricted and because he can 
not join other children of his age in 
various games and sports. 

With time, however, these feelings 
of pity often change. Jealousy may 
develop because of the amount of 
attention given by the parents to the 
handicapped child. In some homes the 
normal children are almost neglected, 
and the parents focus their attention 
on the handicapped child. Jealousy is 
particularly marked if the sibling is 
close in age to that of the handicapped 
child, and also if he is of the same sex. 

Feelings of guilt may arise in the 
sibling. In many cases these develop 
because he becomes disturbed about 
his feelings of jealousy. He feels it is 
wrong, almost "sinful," to have such 
feelings about the brother or sister 



who is so handicapped and whose life 
is so limited. 

If the parents are able to accept the 
child, so will the siblings. Large fa 
milies seem to be able to accept the 
handicapped child better than small 
families. Rural families appear able to 
accept them more adequately than 
urban families. This sensitivity seems 
to come to a peak during adolescence 
and early adult life. It is particularly 
evident in girls who think of marriage 
and who are concerned about the im 
pact of the handicapped child on their 
future husbands. A number are also 
concerned about the possibility of 
having similarly handicaped children 
of their own. 

Effect on handicapped individual 

As the child grows older, the effects 
of his handicap increase and are most 
marked in adolescence and early adult 
life. 

The cerebral palsied child may de 
velop feelings of inadequacy or inferi 
ority because of his inability to take 
part in normal activities, because of 
his physical appearance, or because of 
the limitations imposed on him by the 
treatment of the disease. In addition, 
he may experience a sense of isolation. 
This, to some degree, depends upon 
his inherited personality, but also upon 
his opportunities for contact with other 
children. Some children remain socially 
and emotionally immature because of 
restricted experiences and restricted 
contacts with normal children. 

Anger may be directed against the 
limitations imposed by the disease, or 
may be projected on others. It is often 
projected on the normal siblings be 
cause they have a life that is richer 
and fuller. Occasionally this hostility 
may be projected against the mother, 
whom the child blames for the disease. 

Feelings of anxiety and insecurity 
are particularly evident in older child 
ren who are handicapped. These feel 
ings are well-demonstrated by a girl 
who developed poliomyelitis in ado 
lescence. She was a bright, intelligent 
girl who had previously enjoyed nor 
mal activities. The poliomyelitis was 
severe, and in the early weeks created 
JANUARY 1967 



almost total immobilization. In hos 
pital, she became depressed and was 
referred for psychiatric assistance. It 
soon became obvious that she was 
concerned about her future, feeling 
that she could never support herself, 
would never marry, and would never 
have children. All her plans for the 
future had been destroyed by the 
poliomyelitis. 

It is obvious that the problems will 
be intensified if the individual is intel 
lectually retarded. It is perhaps less 
obvious that they will be intensified 
if the individual shows specific patterns 
of behavior called "the organic brain 
syndrome." The behavioral patterns 
noted in this syndrome include marked 
distractibility, an inability to control 
behavior, and an inability to work 
consistently toward an organized goal. 
There may also be distortions of audi 
tory perception that lead to problems 
in understanding and producing speech, 
or distortions of visual perception that 
may lead to problems in reading and 
writing. D 




JANUARY 1967 



THE CANADIAN NURSE 31 



Recent advances in heart 
surgery 

Today, scientific discoveries are integrated with increasing speed to the field of 
practical application. Heart surgery was born in this age of space exploration and 
gigantic scientific achievements. It has rapidly reached the stage of a 
well-established science. 



Pierre Grondin, M.D., and Claude Meere, M.D. 



In its early stages, surgery of the 
heart was limited to the correction of 
simple congenital lesions. Today open 
heart surgery is capable of correcting 
the more complex forms of congenital 
and acquired heart diseases, and this 
is true even in a far advanced stage of 
the illness. 

At the Montreal Heart Institute, 
surgical procedures have been per 
formed since 1958. As has happened 
elsewhere, there has been a geometric 
progression in the number of cases per 
formed each year and in the steady 
improvement of the results. In the 
seven-year period from 1958 to 1965, 
815 patients underwent intra-cardiac 
operations using extracorporeal circu 
lation. During the first 4 years, 315 
such procedures were performed as 
compared to 500 in the last 3 years. 
The early operative mortality was 35 
to 40 percent, and it has decreased 
progressively during the last period to 
less than 10 percent. This occurred in 
spite of surgical corrections of more 
complex lesions on poor risk patients. 
For instance, during the summer of 
1965, three patients considered mori- 
bunds successfully underwent emergen 
cy surgical correction of multi-valvular 
lesions. 

Extracorporeal circulation 

Improvements in the techniques of 
cardio-pulmonary by-pass have opened 
a completely new area in cardiovas 
cular surgery. To work under direct 
32 THE CANADIAN NURSE 



vision inside the cardiac chambers, all 
venous blood returning to the heart 
must be drained off and returned un 
der pressure in the arterial system. The 
heart-lung apparatus contains three es 
sential parts: a pumping system to as 
sure circulation of the blood, an arti 
ficial lung to oxygenate the blood, and 
a heat exchanger to diminish oxygen 
requirements of the tissues by lowering 
the body temperature. 

In cases where the ascending aorta 
has to be clamped, like in aortic valve 
replacement, an additional system is 
needed to provide each coronary artery 
with oxygenated blood and thus main 
tain viability of the cardiac muscle. 

To collect the venous blood, a can- 
nula is placed in each vena cava via 
the right atrium. The blood is drained 
into the oxygenator either by gravity or 
by suction. In the oxygenator, oxygen 
is brought in contact with the blood to 
increase its available oxygen content. 
The oxygenated fluid then goes into the 
heat exchanger where cooling or warm 
ing is performed. (Figure 1 .) 

To avoid injury of the blood ele 
ments (red cells, leucocytes, etc.) the 
pumps must be as atraumatic as pos 
sible. The blood is returned to the 
body via a cannula which is inserted 
either in the ascending aorta, or in a 
femoral or an iliac artery. To keep the 

Drs. Grondin and Meere are members of 
the Department of Experimental Surgery at 
the Montreal Heart Institute. 



operative field bloodless, a cannula is, 
in most instances, inserted for decom 
pression in the left ventricle through 
the apex. 

Intracardiac operations can be per 
formed by different incisions using a 
right or a left thoracotomy. For several 
years, however, a median sternotomy 
has been commonly utilized, thus 
avoiding opening of the pleura. By this 
sternal approach, we are able to cor 
rect a considerable number of cardiac 
lesions since all the heart valves and 
most of the cardiac chambers are thus 
easily accessible. 

To avoid clotting of the blood in the 
extracorporeal circuit, heparin is given 
intravenously before cannulation of 
the heart and blood vessels. We use 
three mg. of heparin per kilogram of 
body weight. When the intracardiac 
operation is finished, the heparin is 
neutralized by administration of an 
equal amount of protamine. 

In the cardiac surgery, air embo 
lisms must be carefully avoided, be 
cause the presence of gas bubbles in 
small arteries acts as a clot causing 
occlusion. Air emboli in small but im 
portant cerebral arteries are often fol 
lowed by serious neurological deficits. 
Air embolism is prevented first by 
adding filters to the heart-lung appa 
ratus and also by careful evacuation of 
air from the heart chambers before 
returning to normal cardiac function. 

Hypothermia is a valuable aid in 
extracorporeal circulation. Today, 

JANUARY 1967 



Fig. 1 



EXTRACORPOREAL CIRCULATION 




Pump 



only moderate hypothermia is com 
monly used. It consists of a gradual de 
crease of the central body temperature 
from 37 degrees to 29 or 30 degrees 
(centigrade). At this level, oxygen re 
quirements of the tissues are decreased 
by 50 percent. 

Many delicate intracardiac proce 
dures are best performed on a "quiet" 
or arrested heart. Cardiac contractions 
can be stopped by several means. One 
of them consists of inducing a deep and 
selective cardiac hypothermia. These 
low temperatures produce cardiac ar 
rest and/or ventricular fibrillation. 
More recently, we have preferred the 
use of a small electrical current which 
induces and maintains ventricular fi 
brillation. Cardiac arrest induced elec 
trically or by hypothermia is also use 
ful at the end of cardio-pulmonary by 
pass to avoid air embolism. 

Many of the early heart-lung systems 
had a huge priming volume. For in 
stance, the apparatus used at the Mont 
real Heart Institute between 1960 and 
1962 needed some 3500 to 4000 cc. 
The priming fluid consisted at that time 
of whole blood, which imposed a tre 
mendous task upon the blood bank. 
Today this equipment is simplified and 
its priming volume rarely exceeds 1 800 
cc. To further reduce the quantity of 
blood needed for priming, and to 
improve capillary perfusion, we dilute 
the priming volume with 5 percent 
glucose in 0.4 NaCl. The ratio is 2/3 
blood and 1/3 dextrose solution. We 

JANUARY 1967 



also add electrolytes, mainly KCl, to 
prevent postoperative deficit. 

Acquired heart lesions 

The acquired cardiac lesions now 
amenable to surgery are: 1. constric- 
tive pericarditis; 2. aurioculo-ventricu- 
lar dissociation (AV block); 3. massive 
pulmonary embolism; 4. mechanical 
complications of myocardial infarction; 
5. coronary artery insufficiency (angina 
pectoris); 6. traumatic lesions; 7. val 
vular heart disease. 

Constrictive pericarditis 

Pericardial constriction was not un 
usual several years ago. It was pro 
duced in most instances by a tuber 
culous infection. Now, this disease has 
almost disappeared. At the Montreal 
Heart Institute, only three such cases 
have been admitted for surgery since 
1963. The surgical correction consists 
of the removal of the thickened and 
often calcified pericardium, which acts 
as a shell preventing normal cardiac 
contractions. This disease, affecting 
cardiac filling, is frequently mistaken 
for cirrhosis of the liver. Recovery fol 
lowing surgery requires a three to six 
month convalescence, but it is quite 
spectacular in most cases. 

Auriculo-ventricular 
dissociation 

Auriculo-ventricular dissociation 
also called Stokes-Adams syndrome 
was nearly always fatal within two 



years of onset before artificial pace 
makers came into clinical use. In this 
ailment, atrial contractions are not 
transmitted to the ventricles because 
of some organic interference with the 
Bundle of His. The rate of ventricular 
contraction is often less than 40 beats 
per minute and sometimes it reaches 
as low as 25 or even 20 beats per 
minute. Episodes of ventricular ta 
chycardia or prolonged asystole ensue 
and cause inadequate cerebral perfu 
sion resulting in dizziness and/ or syn 
cope. During these periods of asystole, 
ventricular fibrillation is not uncom 
mon and is followed by sudden death 
in most instances. 

AV block is mostly a disease of 
people in their sixth, seventh, or eighth 
decade. It results from a degenerative 
process affecting the intracardiac ner 
vous tissue. However, AV block may 
follow a large myocardial infarct and 
cause a rapid exitus. Treatment of this 
condition with drugs such as isoprote- 
renol is deceiving. The only sure way 
to prevent disaster is to stimulate the 
heart with electricity by an apparatus 
which may be implanted or used ex 
ternally. To avoid Stokes-Adams ac 
cidents, electrodes are implanted into 
the heart using an transvenous catheter 
or by a direct transthoracic puncture. 
Once the patient is protected by ex 
ternal stimulation, an elective opera 
tion can be performed later which con 
sists of the implantation of a small 
transitorized apparatus called a pace- 

THE CANADIAN NURSE 33 



Fig. 2 



CARDIAC PACEMAKER 




(4) Cardiac stimulation 

(3) Wires inserted through the diaphragm 

(2) Rhythmic influx electronic feeding device 



*" (1) Continuous steam power batteries 



maker. (Figure 2.) 

Several types of pacemakers are in 
clinical use. We now prefer a synchro 
nized apparatus (Atricor made by Cor- 
dis Corporation) which seems to offer 
many advantages over the earlier fixed- 
rate models. The synchronous or P- 
wave pacemaker provides a better car 
diac output because it regulates the 
ventricular contractions to the atrial 
systoles. It thus permits variations in 
the cardiac rhythm and output ac 
cording to the needs of the body. 

The surgical procedure of pace 
maker implantation is simple and its 
mortality is very low. Patients as old 
as 89 years of age were operated on 
successfully at the Montreal Heart In 
stitute and no operative mortality has 
been deplored. 

Massive pulmonary embolism 

In recent years, the heart-lung ma 
chine has been simplified rendering 
possible its preparation for cardio-pul- 
monary by-pass in a matter of minutes. 
The cardiac surgeon is capable of re 
moving massive pulmonary emboli as 
an emergency procedure and saves 
many lives that formerly were lost. The 
treatment consists of extracting the 
clots from the main pulmonary artery 
and its branches. In most cases the 
procedure is complemented by liga- 
tion of a plication of the inferior vena 
cava to prevent recurrent onbolization. 
At the Heart Institute, preparation for 
cardio-pulmonary by-pass can be made 

34 THE CANADIAN NURSE 



in 15 minutes for such emergencies. 

Mechanical complications of 
myocardial infarction 

Even though surgery is limited in the 
treatment of myocardial infarction, 
mechanical complications of this dis 
ease such as ventricular aneurysms, 
perforations of the septum, and rup 
tures of papillary muscles - - can be 
corrected surgically. After an extensive 
coronary thrombosis, some patients 
develop an abnormal dilatation of the 
left ventricular wall. The dilatation 
causes chronic heart failure, mostly 
because of its paradoxical motion. 
These cases respond poorly to medical 
management because the dilated ventri 
cular wall has no contractile strength 
and has a paradoxical expansion 
during each systole. Cardiac output is 
thus markedly reduced. We have cor 
rected four such aneurysms with three 
survivals. The operation is rather sim 
ple. The dilated wall is excised, and 
the mural thrombus removed. The 
ventricular edges are then resutered. 
Postoperatively, these patients are 
markedly improved and can resume 
useful activities. 

Perforation of the septum following 
cardiac infarction is uncommon. Some 
authors report a 50 percent death rate 
within the first week after perforation 
and a survival rate of only 13 percent 
after two months. The surgical pro 
cedure consists of closing the perfo 
rated septum under cardio-pulmonary 



by-pass. Three such procedures have 
been performed at the Montreal Heart 
Institute with gratifying results. 

Coronary artery insufficiency 

Chronic coronory insufficiency is the 
most common acquired heart condition 
of our modern time. Until recently, 
even adequate medical therapy with 
vasodilators or anticoagulants and as 
sociated cessation of all activities was 
unable to lower the mortality rate. 

For the past 15 years various surgi 
cal procedures have been advocated, 
primarly by Beck, O Shaughnessy and 
Vineberg. At present, the implantation 
of the internal mammary artery (called 
Vineberg s procedure) is currently per 
formed in some 25 Canadian and 
American centers. This experience, al 
though recent, is quite encouraging. 

Surgical technique consists of im 
planting a systemic artery (the internal 
mammary, an intercostal or a venous 
graft from the descending thoracic 
aorta, etc.) into a myocardial tunnel. 
For diffuse coronary artery disease, an 
epicardectomy is often added along 
with a free omental graft which is 
wrapped around the heart muscle. 
Postoperative cine-angiographic studies 
have shown beyond any doubt satis 
factory patency of the implanted artery 
and newly developed collateral bran 
ches. According to more recent studies, 
after eight months the blood flow into 
the implanted artery is equal to the 
flow in a normal anterior descending 

JANUARY 1967 



Fig. 3 




-,.,- 



Commonly used artificial heart valves. 
Left to right: Starr aortic; Starr mitral; 
Magovern aortic; Cutter; and Hufnagel 
valve. 



coronary artery. These surgical pro 
cedures are promising and will play 
an important role in the treatment of 
chronic coronary insufficiency. 

Traumatic heart disease 

Trauma to the heart is not always 
lethal, fortunately. If one adopts a 
prompt and aggressive attitude, it is 
possible to salvage a good proportion 
of such cases. 

All authors agree that upon admis 
sion, when a cardiac wound is sus 
pected, a pericardial puncture must be 
performed. By this maneuver the 
diagnosis is confirmed and cardiac 
compression, if present, is temporarily 
relieved. If cardiac tamponnade recurs, 
the heart should be explored and the 
wound sutured. 

Diseases of the heart valves 

Modern cardiac surgery is now con 
centrating its energy in the correction 
of valvular lesions. Except in cases of 
pure and non-calcified mitral stenosis 
(adequately treated by commissuroto- 
my) the correction of valvular disease 
requires the insertion of a prosthetic 
heart valve. A variety of prostheses are 
available, but all have the same hy 
draulic principle of the ball-valve des 
cribed by Starr and Edwards in 1960. 
(Figure 3.) 

The pros and cons do not differ 
much from one type to another. In all, 
anticoagulants must be prescribed for 

JANUARY 1967 



the entire life of the patient. These 
artificial valves may become partially 
dislodged, throw emboli, or become in 
fected. More recently, Gordon Murray, 
Donald Ross, and Barrat Boyes have 
popularized the use of homograft 
valves. The danger of embolization and 
infection seems to be lessened with 
these homografts. 

At the Montreal Heart Institute, 
more than 190 patients have been 
operated on for valvular replacement. 
Of this group, 27 have had simultane 
ous replacement of two valves, either 
the mitral and aortic in 23 cases, or 
the mitral and tricuspid in 4 cases. 

These patients were operated upon 
at a far advanced stage of the disease 
and long term results are very satis 
factory. An impressive number of these 
patients have returned to a near 
normal and productive life. 

Conclusion 

In recent years, heart surgery has 
reached more unexplored goals than 
any other surgical discipline. After es 
tablishing satisfactory procedures for 
several acquired lesions such as val 
vular malfunctions, AV blocks and 
mechanical complications of myocar- 
dial infarction, cardiac surgery is now 
claiming continuing success in the 
revascularization of the myocardium. 
Coronary artery disease affects, in the 
United States alone, more than 25 mil 
lion people. Most authors agree that 



about 5 million such patients can now 
benefit from revascularization proce 
dures. These accomplishments illustrate 
the enormous possibilities of surgery 
in cardiovascular ailments. A great 
number of cardiac cripples can now be 
rehabilitated to a useful life. D 



THE CANADIAN NURSE 35 



Intensive care unit 

in cardiovascular surgery 

A description of the intensive care setup at the Montreal Institute of Cardiology. 



An intensive care unit for patients 
having cardiovascular surgery is de 
signed to decrease mortality rate and 
to give patients the benefit of highly 
technical care and close observation. 
Such a unit, with its up-to-date equip 
ment and well qualified personnel, 
helps to eliminate the unfavorable 
effects of anxiety and fear that may 
predispose to postoperative complica 
tions. 

Physical organization 

The intensive care unit for cardio 
vascular surgery is not merely a re 
covery room. Patients are admitted 
as soon as they come out of the operat 
ing room and the average stay is five 
days. 

To serve both operating rooms of 
the Montreal Institute of Cardiology, 
13 beds are provided in two six-bed 
units and one isolation room. The iso 
lation room is used to ensure quietness 
and privacy to a severely ill patient, 
to isolate a patient with an infectious, 
disease, or to permit the assembly of 
all machines and equipment together in 
one area for a seriously ill patient. 

A two-bed room is available for 
patients who have not had surgery, but 
whose condition requires close super 
vision. This includes persons with acute 
pulmonary edema, babies or infants 
who have had heart catheterization, 
and patients being observed after atrial 
defibrillation. 

Space allotted: Approximately 108 
square feet are allotted to each patient. 

36 THE CANADIAN NURSE 



Cecile Boisvert 



This provides sufficient space for 
equipment and additional personnel in 
case of emergency. 

Direct observation: No system of 
automation, whether it be heart mon 
itors or other electronic instruments, 
can replace direct observation. For 
this reason, the central station is 
located so that each patient can be 
watched at all times. 

Waiting room for visitors: Even 
though visits are restricted, a waiting 
room in close proximity to the post 
operative unit is provided for parents 
and relatives. 

Air conditioning: A system of air 
conditioning is essential, not only for 
the comfort of patients and staff, but 
also to offset the heat produced by 
many electronic instruments. Ade 
quate humidity is also required to keep 
mucous membranes moist and to 
facilitate expectoration of bronchial 
secretions. 

Equipment 

Oxygen and suction: Each unit has 
two oxygen outlets and two wall 
suction connections. One suction outlet 
is for chest drainage and the other for 
oro-nasal or endotracheal aspiration of 
our patients. 

Miss Boisvert, a graduate of St-Joseph s 
Hospital in Trois-Rivieres, Quebec, special 
ized in cardiology at 1 Institut Marguerite 
d Youville in Montreal. She is Head Nurse 
of the Intensive Care Unit at the Montreal 
Institute of Cardiology. 



Electrical: Electrical outlets are 
numerous since many electrical de 
vices are used in the various types 
of treatment. Five double outlets, 
separately fused, are provided per 
patient and a special outlet is available 
in each unit for taking chest x-rays 
at the patient s bedside. 

Monitoring and alarm systems for 
emergencies: The heart monitor is of 
special assistance when observing pa 
tients who have had cardiovascular 
surgery. Numerous complications and 
even fatal outcomes have been avoided 
through the use of such devices. 

A recently published report of 
research undertaken by a team of 
physicians and nurses at the Presby 
terian Hospital of Philadelphia states: 
"If the heart rhythm can be constan 
tly observed through the use of mon 
itors, and if the equipment necessary 
for resuscitation is kept near the pa 
tient, potentially fatal arrhythmias may 
be detected and treated instantly. Total 
mortality in patients having a myocar- 
dial infarct, at the acute stage, may 
thus be reduced by almost 50 per 
cent."* 

The monitoring system at the Mon 
treal Institute of Cardiology includes 
a central complex of monitors which 
indicate heart rhythm, ECG tracing, 

* Lawrence Meltzer, Rose Pinneo, Roderick 
Kitchell, Intensive Coronary Care A 
Manual for Nurses, Philadelphia. The Pres 
byterian Hospital, 1965. 
** Ibid. 

JANUARY 1967 




Eight-bed central station using Selector 
Monitor with repeat meters and alarm 
lights. A single channel recorder is in 
cluded for automatic or manual opera 
tion. 



and the curve of the peripheral pulse 
of each patient. This central complex 
is located in the nursing station and 
is connected to the cardioscope at the 
bedside. 
The monitoring system also contains: 

a) An alarm system that warns the 
staff if the patient showns signs of 
ventricular fibrillation, tachycardia or 
bradycardia. 

b) A mechanism that operates auto 
matically or on demand to provide a 
recording on paper of a particular or 
doubtful ECG tracing which the nurse 
has been able to observe on the oscil 
loscope. These ECG tapes help the 
physician to assess the patient s condi 
tion; for the nurse, they are indisputa 
ble arguments to justify her observa 
tions. 

c) A "memory tape loop" that 
records and retranscribes on paper the 
ECG of the previous three to five 
minutes. With this device, it is possible 
to determine what happened immedia 
tely before or after the alarm was set 
into action. 

Needle electrodes: The use of needle 
electrodes for ECG has numerous ad 
vantages. They can be installed in a 
few seconds - - an essential in an 
emergency and eliminate false 

alarms and interference because of a 
poor skin contact. 

Needle electrodes can be left in 
place five to seven days without caus 
ing the patient discomfort. The skin 
is cleansed with alcohol before the 

JANUARY 1967 



needle is inserted, to eliminate the pos 
sibility of infection. 

Emergency equipment 

In an intensive care unit, all equip 
ment and drugs must be kept in a 
central location. There can be no com 
promise with this principle. 

Emergency cart: All equipment used 
for resuscitation is assembled on a 
mobile cart that can be rolled quickly 
from the central station to the patient s 
bedside. This represents savings both 
in time and equipment. This cart con 
tains: a), a portable DC defibrillator 
with electrodes and conductive jelly; b). 
lung ventilation equipment, including 
"Resuscitube," intermittent positive 
pressure apparatus, and endotracheal 
tubes and laryngoscope; c). external 
heart massage equipment, including a 
wooden board, measuring about 3 x 2 , 
to place under the patient s chest, or 
an automatic mechanical compressor; 
d). venous dissection equipment; e). 
tracheotomy and tracheal cannulas; f). 
instruments necessary for emergency 
thoracotomy; g). drugs, including epi- 
nephrine, norepinephrine, Aramine, 
Isuprel, bicarbonate of sodium, calcium 
chloride, and Pronestyl; h). sterile 
gloves, syringes, needles, etc. 

The contents of the emergency cart 
are checked carefully each day and 
each time after they are used. 

Personnel 

The care of patients having heart 
surgery involves team work. Good 



results cannot be obtained without 
close cooperation between each mem 
ber of the team. 

Surgeons assume the responsibi 
lity for patients in the intensive care 
unit, and the residents in cardiovas 
cular surgery are entrusted with the 
supervision of patients during the entire 
postoperative period. 

Distribution of nursing staff: Any 
patient who has had cardiovascular 
surgery requires nursing care of a truly 
high caliber. To meet such an objec 
tive, a strict minimum of eight hours 
care must be provided for each patient 
in a 24-hour period. The nurse s aide 
contributes by performing certain tasks, 
such as bathing the patient, changing 
his bed linen and helping him to eat. 

Selection: Careful selection of nurs 
ing personnel is essential. Desirable 
personal attributes include: an ability 
to learn and assimilate new techniques 
quickly; emotional stability, which 
allows a person to face emergency si 
tuations efficiently; good health, since 
much physical effort is required in the 
unit; a marked interest in and dedica 
tion to this type of work. 

Previous experience in a recovery 
room or intensive care unit is a great 
asset. It is not, however, a requisite for 
employment. 

Status: Because of the responsibil 
ities that the nurses in this unit must 
assume, it is logical that they should 
have a distinctive status and that their 
experience be recognized. 

THE CANADIAN NURSE 37 



INTENSIVE CARE UNIT 
IN HEART SURGERY DEPARTMENT 



CH 



ED 

EH 



EH 



ISOLATED 
ROOM 



CENTRAL 
STATION 



MONITORING 
PANEL 

JL 



EH 1 




PHARMACY 



Salary should be commensurate with 
their position. Rose Pinneo, in 
Intensive Coronary Care A Manual 
for Nurses, suggests a salary approxi 
mately 15 percent higher than that 
of the basic staff nurse.** This has 
become policy at most hospitals. 

Staff orientation 

Orientation extends over a period 
of about three weeks, during which 
time the nurse is called upon to assume 
increasingly greater responsibilities. 

Under the guidance of an experienc 
ed nurse, the new staff member has 
an opportunity to observe patients. 
This phase of learning is planned in 
advance, not left to chance. New tech 
niques are taught whenever the occa 
sion permits. 

The surgeons, cardiologist, and resi 
dents present lectures and clinics for 
the nurses benefit. Topics include: 
anatomy and physiology of the cardio 
vascular system; pathology of the heart; 
surgical operations for heart disease; 
drugs used in heart surgery; treatment 
of various arrhythmias; postoperative 
complications and preventive measures; 
oxygen therapy; psychological prob 
lems of patients having heart surgery; 
and rehabilitation. 

Each staff member is expected to 
learn, through personal reading, about 
ECG tracings and the various arrhyth 
mias. 

Certain techniques and procedures 
must be learned. These include: mea 
surement of venous pressure; ope- 

38 THE CANADIAN NURSE 



ration of the cardioscope and pace 
maker; use of the thermo-regulator 
mattress; handling of the various res 
pirators; techniques of resuscitation 
and external heart massage; and defi- 
brillation in ventricular fibrillation. 

At the Montreal Institute of Car 
diology, the nurse has the right, in cer 
tain circumstances, to carry out ven 
tricular defibrillation, that is, to give 
the patient an electric shock of 300- 
500 watts per second. Ventricular fi 
brillation is an extremely serious 
arrhythmia that may cause death if 
nothing is done within three minutes. 
If the nurse encounters ventricular fi 
brillation in a patient, she must advise 
the surgeon immediately; if, after 60 
seconds, he has not arrived, she starts 
electrical defibrillation to reestablish 
normal heart rhythm. In such circums 
tances, the surgeon assumes full res 
ponsibility for her action. 

To familiarize the staff with proce 
dures performed in an emergency, a 
particularly critical emergency is simul 
ated using a dummy or a member of 
the staff as a patient. The nurse must 
act exactly as if she were faced with 
a real case of cardiac arrest or a pa 
tient who has suddenly developed ven 
tricular fibrillation. Her actions can 
then be assessed and she can be hel 
ped to improve her technique and save 
time. 

Care is never routine 

Nursing care in cardiology can never 
become a matter of routine. It is given 



on an individual basis according to 
age, type of disease, seriousness of the 
illness and the patient s attitude toward 
his condition. 

The nurse must also be concerned 
with the patient s rehabilitation. She is 
in a better position than anyone else to 
help him achieve successful rehabili 
tation. 

Nursing care in heart surgery is a 
real challenge to any nurse. Although 
the work is exacting and the responsibi 
lities heavy, the reward, also, is great. 
The nurse is compensated for her ef 
forts when she sees the patient leave 
hospital improved or cured and when 
she knows that she has given him the 
best of her knowledge and skill in the 
most difficult circumstances. D 



JANUARY 1967 



Varicose veins of the 
lower limbs 



About 10 percent of all adults over thirty-five years of age have some degree of 
varicose change in their saphenous venous system. 



Varicose veins are characterized by 
permanent overdistention and changes 
of their walls. This paper deals with 
varicose veins involving the super 
ficial venous network of the lower 
limbs, especially those situated along 
the internal and external saphenous 
veins. 

Etiology 

Varicose veins usually appear in the 
young adult and increase with age. 
They occur about four times more 
frequently in females than in males. 
They are observed especially in per 
sons who must stand at their work for 
long periods without moving. Their 
development is, moreover, enhanced 
by frequent pregnancies. 

There is often a hereditary factor in 
volved. Some persons seem to have a 
constitutional weakness of the valves of 
the veins and an abnormal propensity 
to distention of the venous walls. In 
a study of 1,500 patients with vari- 
cosities, Raymond Tournay found a 
hereditary factor in 90.6 percent. 

The maternal or the hereditary 
influence from the mother s side is 
found in 55 percent of patients. Thirty- 
three percent of the women with vari- 
cosities developed them during their 
first pregnancy. 

Physiopathology 

Normally, venous circulation return 
ing from the lower limbs results from 
the suction effect of the heart and the 
pulsion effect of the muscular massage 

JANUARY 1967 



Philippe Dionne, M.D. 

on the deep veins and, indirectly, on 
the superficial veins. Venous flow thus 
goes from the saphenous veins to the 
deep veins. Both mechanisms work 
against two contrary movements: res 
piration and hydrostatic pressure. 

One theory of varicosities is that the 
venous backflow pushes the blood from 
the deep veins toward the superficial 
veins by means of communicating 
veins, causing gradual dilatation of the 
superficial veins. It is known, however, 
that these communicating veins contain 
valves that allow the blood to circulate 
only from the surface toward the deep 
veins. (Figure 1 .) Nevertheless, when 
varicose veins have already appeared, 
the valves of the communicating veins 
may be forced, little by little, allowing 
the backflow to by-pass them, thus 
increasing varicose distention. This ex 
plains the aggravation of varicose veins, 
but not how they started. 

At the present time, Trendelenburg s 
theory is the one generally accepted: 
the appearance of varicose veins is 
related to the incompetence of the 
ostial valve situated at the opening of 
the internal saphenous vein into the 
femoral vein. (Figure 2.) The main 
branch of the internal saphenous sup 
ports all the pressure of the abdominal- 
thoracic blood column, since there is 
no valve between this point and the 
heart. Thus, the first segment of the in- 

Dr. Dionne is a member of the surgical 
staff at St. Vincent-de-Paul Hospital. Sher- 
brooke. Quebec. 



ternal saphenous dilates, and the 
valve closing it at the lower segment is 
forced, bringing about distention of the 
second segment, and so forth. From 
one point to the next, the weight of the 
blood column exerts pressure right 
down to the lower part of the leg. 

This valvular incompetency theory 
has been proved by clinical and ex 
perimental evidence. Other factors, 
too, may cause a lack of venous tonus 
which favors distention. 

Types 

There are two main types of vari 
cose veins: essential or idiopathic, and 
secondary, also called substitute or 
compensating. 

All varicose veins of the lower limbs 
are superficial in nature. Certain 
authors speak of "deep" varicose veins; 
however, the anatomy and physiology 
of venous circulation in the lower limbs 
allow us to state definitely that the 
deep veins are not involved in the 
pathological enlargement. Deep varico 
sities just do not exist. The term has 
merely been used to describe patients 
complaints of a feeling of heaviness, 
strain, and cramps in the calves of the 
legs after a long period of standing. 
Such discomfort may be the beginning 
of the complication of internal rupture, 
which will be described later. 

Secondary or "substitute" varicose 
veins are characterized by dilatation 
of the superficial venous system. This 
dilatation acts as a compensation fol 
lowing deep vein thrombophlebitis. 

THE CANADIAN NURSE 39 




Fig. 1 . Diagram showing valves in a 
communicating vein. 1) Femoral vein; 
2) internal saphenous vein; 3) commu 
nicating vein; 4) normal valve that 
opposes flow from the larger vessel 
back into the superficial vessel. 




Fig. 2. Because of insufficiency of the 
ostial valve, the first segment of the 
internal saphenous dilates with corres 
ponding pressure on the collateral cir 
culation. The second valve is then 
forced and the second segment dilates, 
and so on. 1) Femoral vein; 2) pro- 
funda femoral vein; 3) superficial 








Fig. 3. Varicosities of lower leg. 



femoral vein; 4) first segment of 
internal saphenous vein; 5) ostial 
valve; 6) second valve; 7) openings of 
collateral saphenous circulation. 






Fig. 4. Top: After elevation of the leg, 
compression is applied to the saphenous 
vein. Middle: Leg is lowered and 
varicosities do not appear. Bottom: 
When compression is stopped the 
varicosities immediately appear. 



Fig. 5. Left: Subject standing severe 
varicosities apparent. Middle: Subject 
lying down, leg in air varicosities 
collapse. Right: Subject standing with 
tourniquet obstructing the internal 
saphenous varicosities remain col 
lapsed, but are scarcely visible. When 
the restriction is removed, the varico 
sities will fill up from top of leg toward 
ankle, which indicates valvular insuf 
ficiency at the junction of the internal 
saphenous. 




40 THE CANADIAN NURSE 



JANUARY 1967 




Fig. 6. Varicose ulcer. 



Secondary varicose veins are late 
complications that can be caused by 
deep thrombophlebitis in the same man 
ner as the post-phlebitic syndrome and 
the post-phlebitic ulcer (stasis ulcer). 

Essential or idiopathic varicose veins 
represent the group of common vari 
cose veins that develop spontaneously 
in the absence of deep venous obstruc 
tion. A hereditary factor is involved. 

Anatomic pathology 

At first, the clusters of varices 
remain localized in restricted areas. Af 
ter progressing for a certain time, 
the varices finally invade the whole 
area of the internal saphenous vein 
and sometimes also the area of the 
external saphenous. 

Macroscopically, the affected veins 
are dilated, tortuous, and fluctuant, 
due to their secondary lengthening. 
Their walls are usually thin and calci 
fied in places. The dilatations often 
contain calcifying clots (phleboliths). 

Under a microscope, a thickening of 
the tunica can be seen in the early 
stage of the varix. Later, this is re 
placed by atrophy with sclerosis. 

Changes occur in other tissues of 
the limb. The sclerous tissue around 
the varices finally reaches the nerves 
and the arteries; the subcutaneous cel 
lular tissue atrophies and becomes the 
site of an edematous infiltration. The 
skin also undergoes important changes. 
It becomes white and glossy in places, 
dry, scaly, and pigmented in others. 
Eczematoid lesions appear and the skin 

JANUARY 1967 



soon becomes badly ulcerated. 

Clinical picture 

Few functional symptoms are evident 
at first. The patient may complain of 
heaviness and fatigue of the limb, with 
malleolar edema in the evening, in 
creased by standing. Later, he may 
experience acute pain in the form of 
leg cramps. 

The physical signs consist of veins 
that are dilated in the form of bluish 
cords, and uneven flexuosities, situated 
most frequently along the internal sa- 
phena, i.e., along the inner surface of 
the thigh and the leg. Varicose veins 
partly disappear when the patient is 
recumbent in the supine position. They 
can be partially reduced by pressure. 
(Figure 3.) 

The Trendelenburg test helps to de 
termine the location of incompetent 
valves. With the patient lying down, 
the leg is elevated to empty the super 
ficial veins. The outlet of the saphena is 
compressed and the patient then is 
asked to stand. If the ostial valve is 
incompetent, the varicose veins fill 
again suddenly from the top to the 
bottom as soon as the digital compres 
sion is removed. (Figure 4.) 

The Trendelenburg test may also 
be used to demonstrate incompetent 
perforating veins. The limb is raised 
to empty the saphenous; the outlet of 
the saphenous is compressed, and the 
limb then is lowered without stopping 
compression. If the perforating veins 
have competent valves, the vein fills 



slowly; if the perforating veins do not 
have competent valves, filling occurs 
rapidly. (Figure 5.) The multiple-tour 
niquet test is also helpful in locating 
the position of incompetent perforating 
veins. 

Perthes test, which consists of com 
pression of the saphenous trunk in the 
thigh followed by exercise carried out 
by the patient, is useful to evaluate 
the patency of the deep venous system. 
If the deep veins are blocked, the vari- 
cosities become enlarged and the pa 
tient feels a pain in the calf of the leg. 

Phlebography supplies two types of 
information: it helps the physician to 
evaluate the deep circulation and to 
localize the incompetent perforating 
veins. 

Complications 

Complications represent the serious 
aspects of varicose veins. 

1. Rupture: External rupture occurs 
through a gradual thinning of the 
dermis over a dilated varix. Suddenly, 
without apparent cause or pain, the 
hemorrhage occurs. Although it may 
be serious, it can usually be controlled 
by elevating the limb and applying a 
pressure bandage. 

Internal rupture occurs over the 
deep veins of the calf. The patient ex 
periences a sharp and sudden "whip 
lash" pain followed by lameness. In the 
ensuing days a painful induration ap 
pears over the calf of the leg, oc 
casionally accompanied by ecchymosis. 

2. Varicose phlebitis: This com- 

THE CANADIAN NURSE 41 



plication, which generally involves the 
superficial varicose veins, is common. 
Clinically, edema and local erythema 
are noted. The venous cord becomes 
hard, knotty and painful. Sometimes 
the phlebitis will extend the entire 
length of the internal saphenous. It 
rarely gives rise to emboli, but is 
stubborn and recurring. More often 
than not, the inflammation subsides, 
leaving an indurated cord; however, 
it may progress to suppuration. 

3. Trophic skin : Patches of pig- 
mented skin and dry or oozing eczema 
are commonly found. 

4. Varicose ulcer: This is the most 
common and most serious complica 
tion, since it resists treatment and 
recurs easily. (Figure 6.) Its pathogeny 
is complex. Nutrition of the tegument 
of a varicose limb is poor for two 
reasons: venous stasis and nerve 
changes as a result of sclerosis. 
Clinically, the varicose ulcer is observ 
ed most frequently in the lower half 
of the inner surface of the leg. It 
begins following minimal excoriation 
of the skin, caused by trauma or 
eczema. 

The ulcer gradually enlarges and 
may reach considerable dimensions. 
Its edges are sharp, quite regular, thick 
and adherent. The base of the ulcer is 
irregular, greyish, and atonic, and 
secretes a turbid serous discharge. The 
skin surrounding the ulcer is brownish 
in color. If not treated properly, the 
ulcer gradually increases in size. With 
adequate treatment it may be cured, 
but it recurs with extreme facility. 

The common varicose ulcer must be 
differentiated from the post-phlebitic 
chronic ulcer or "stasis ulcer," which 
represents a separate entity. The latter 
is found in patients who have suffered 
deep phlebitis of the lower limbs some 
years previously and who, afterwards, 
have shown the syndrome known as 
the "post-phlebitic leg": vague pain; a 
feeling of heaviness, fatigue, and 
cramps in the affected limb; and the 
appearance of hard and sometimes 
ligneous edema. At first, the skin has 
a smooth, glossy appearance with 
brownish-red pigmentation. 

Although varicosities may not exist 
prior to or during the course of the 

42 THE CANADIAN NURSE 



phlebitis, they may appear later. After 
ward, the ulcer sets in and resists 
almost any type of treatment. 

Our present knowledge of the causa 
tive mechanism of "stasis ulcer" now 
enables us to treat it successfully with 
surgery. Deep thrombophlebitis, in its 
acute phase, completely blocks the 
deep vein of the limb. With time and 
treatment, the acute phase subsides. 
Later, the vein becomes more or less 
permeable again, but like a rigid tube, 
having lost its elasticity. Muscular mas 
sage is no longer effective; hence, there 
is a backflow through the communicat 
ing veins and a consecutive stasis in the 
superficial venous network with the 
onset of substitute varicose veins and 
a stasis ulcer. 

Treatment 

Uncomplicated essential varicose 
veins are relatively easy to manage. 
Small varices that give little trouble can 
be treated by having the patient wear 
elastic stockings; the compression thus 
achieved is sufficient to prevent the 
evolution of lesions. If, however, the 
patient refuses to wear elastic stockings 
permanently, sclerosing solutions can 
be injected particularly in the case of 
moderate and well-localized varicose 
veins. The injection of sclerosing solu 
tions has a positive effect; this treat 
ment involves little risk, allows the 
patient to be ambulatory, and has the 
advantage of curing the disorder with 
out leaving scars. The injected scleros 
ing solution induces a localized obli 
terating endophlebitis which transforms 
the varix into a solid cord. 

The purpose of the sclerosing treat 
ment is to prevent lesions and later 
complications from developing. It will 
give excellent results if it is started 
early and if the patient regularly visits 
his physician to have him sclerose any 
ulterior varicose dilatation. It will be 
more effective if the patient is well 
aware of his or her condition and 
understands the importance of wearing 
elastic stockings. 

If, however, the patient refuses to 
wear such stockings; if he or she does 
not want to undergo the continuous 
sclerosing treatment; if the varicose 
veins are enormous; or if the patient 



shows one of the serious complications 
of varices, surgery is the only effective 
treatment. The latter consists of the 
division of the great saphenous vein 
at the saphenofemoral junction, with 
ligation of all its collaterals, and the 
stripping of the entire internal saphe 
nous vein from the groin to the internal 
malleolus. If indicated, the perforating 
veins, especially those in the upper 
third of the leg, are ligated as well. 

Sclerosing solutions may be injected, 
if necessary, pre- or postoperatively to 
avoid too many scars. After surgery, a 
compression bandage is applied to the 
limb to prevent hemorrhage. 

Walking is resumed the following 
day to avoid stasis and deep thrombo 
ses. The functional and esthetic re 
sults of such operations are excellent. 

The destruction or eradication of 
the varicose veins by surgery automa 
tically cures a varicose ulcer. If, 
however, the ulcer is of a large di 
ameter, over 2 cm., for instance, its 
recurrence will be prevented by ex 
cising the ulcerated area and applying 
a dermo-epidermal graft. 

The recurring post-phlebitic ulcer 
(stasis ulcer) is treated surgically ac 
cording to a special technique, after 
the surgeon has made certain that the 
deep circulation is adequate. The ulcer 
is widely excised to the level of the 
fascia; then, the underlying perforating 
veins are ligated even beyond the 
fascia to block the backflow to the 
surface. Frequently, the detachment of 
a large flap that includes the fascia 
helps the surgeon to ligate the perforat 
ing veins beyond the ulcerated areas. 
Finally, a dermo-epidermal graft com 
pletes the procedure. 

Secondary varicose veins that ac 
company the ulcer are treated as essen 
tial varicose veins. Faced with a 
varicose ulcer and varices complicated 
by obstruction of the deep circulation, 
the surgeon has the worst problem to 
solve. The stripping of part of the 
varicose veins may improve the limb. 
In addition, instructions to the patient 
about the importance of decreasing 
stasis and avoiding trauma, even the 
slightest one, may help him to avoid 
complications and minimize his dis 
ability, n 
JANUARY 1967 



Nursing care in 
varicose vein surgery 

Teaching the patient ways to help prevent the recurrence of 
varicosities is an important aspect of care. 



The patient who is to have ligation 
and stripping of varicose veins is 
usually admitted one or two days prior 
to surgery. Preoperative nursing care 
is started immediately. 

Preoperative care 

The patient is allowed out of bed 
only to go to the washroom. She wears 
elastic bandages on her legs at all times 
to prevent blood stasis in the veins. 
The nurse explains and demonstrates 
the correct procedure for applying the 
bandages. 

Two four-inch-wide bandages are 
used for each leg and are applied by 
the patient before rising in the morn 
ing. Prior to this she elevates both 
legs for about four minutes to drain 
blood from the veins by gravity. 

To be useful, the bandages must be 
applied correctly. Wrapping should 
start close to the toes, with three turns 
around the foot and three figure-8 
turns around the ankle. The second 
bandage is then continued up the leg, 
using spiral-reverse turns to provide 
better support and to avoid uncomfort 
able folds. The compression of the 
bandage must be strong over the feet 
but less at the ankles and the calves, 
to avoid edema of the feet and toes. 
The foot of the bed should be raised 
by two or three notches (about eight 
inches). 

Physical preparation also includes 
teaching the patient the various respir 
atory and spirometric exercises that 
she will be required to carry out post- 
operatively. 
JANUARY 1967 



Murielle Rodrigue 

Psychological preparation is as im 
portant as physical. All procedures are 
explained to the patient, and she is 
given an opportunity to express her 
fear of pain and discomfort. In certain 
cases, apprehension may be due to 
fear of the recurrence of the varico 
sities after surgery. The nurse explains 
that the operation is a successful form 
of treatment, and that active treatment 
at this stage will avoid later complica 
tions such as phlebitis, ruptures, vari 
cose dermatitis and ulcers. 

On the evening before surgery the 
pubis and both legs are shaved. Shav 
ing is done carefully, since the skin 
over the varicose veins is very thin and 
fragile. Cuts and scratches could lead 
to infection and thus to postponement 
of the surgery. The risk of infection is 
reduced by applying Betadine soap, 
which contains 0.75 percent of free 
iodine, to the legs. 

The nurse takes this opportunity to 
explain to the patient the dangers of 
using a depilatory cream, especially if 
there is an ulcer. These substances are 
much too irritating for delicate skin 
and may cause a dermatitis to develop. 

Postoperative care 

A cradle is placed on the patient s 
bed to prevent the weight of the bed 
clothes from resting directly on her 
legs. The foot of the bed remains rais- 

Miss Rodrigue is Supervisor and Clinical 
Instructor of Surgical Nursing at the St. 
Vincent de Paul General Hospital School 
of Nursing in Sherbrooke, Quebec. 



ed by 8 inches to aid venous return. 

In addition to routine supervision, 
the nurse closely observes the incisions 
in the region of the groin, knee or 
instep for possible hemorrhage or 
hematomas. If there is bleeding, she 
applies manual pressure over the area 
and notifies the doctor. She also notes 
the color of the skin and any edema of 
the toes. 

Except by order of the physician, 
bandages around the legs are not re 
moved. Only the surgeon or his assis 
tant changes the dressings. 

The patient is encouraged to move 
her toes, ankles, and legs as soon as 
possible after the operation, even if 
this is painful. The nurse remains with 
her as she attempts these exercises for 
the first time, to give her moral sup 
port. She explains that the stitches will 
not give and that the sooner and more 
frequently the patient makes these 
movements, the sooner the pain will 
disappear. Generally the patient is al 
lowed to walk the day after surgery. 

Early ambulation 

The patient may complain of a tug 
ging pain over the groin, caused by 
the dressing and the stitches, when she 
first walks. She is warned not to touch 
the dressings, as there is a risk of 
contaminating the wound. If edema ap 
pears in the limb during ambulation, 
the patient is put back to bed with 
her legs raised on pillows. 

The patient should walk about and 

not remain standing. It is preferable 

for her to get up several times a day 

THE CANADIAN NURSE 43 




44 THE CANADIAN NURSE 



for short periods each time. When she 
is sitting, she should prop her legs on 
a stool. 

Convalescence 

The nurse gives the patient general 
instructions about future care to 
prevent the recurrence of varicosities. 
She advises the patient to continue to 
wear the elastic bandages until the 
doctor suggests that she wear elastic 
stockings. Both stockings and bandages 
should be put on in the morning and 
left on until bedtime. 

The patient is told that she can 
prevent dryness of the skin and scaling 
by applying vaseline or a lanoline-base 
oil; any other medicated ointment 
should be avoided. In addition, she 
should not scratch her legs, because of 
the danger of producing a varicose der 
matitis. 

The nurse explains why the patient 
should avoid wearing stocking sus 
penders or panty girdles which com 
press the veins in the area of the groin 
and the thigh. She warns the patient 
against crossing her legs when sitting, 
and standing for prolonged periods. 
She suggests that the patient should 
raise the foot of her bed at night, and, 
two or three times during the day, 
allow about 20 to 30 minutes of rest 
with legs elevated. 

The patient is told to avoid any 
trauma that might bruise, scratch or 
cut her legs. If her limb is injured in 
any way, she should inform her phy 
sician. 

Patients suffering from varicose 
veins should consult their physician 
regularly two or three times a year, 
especially if they have undergone 
surgery. This enables the surgeon to 
give better follow-up care to his patient 
and to find out if she has really 
followed his instructions. 



The nurse explains and demonstrates 
the correct procedure for applying 
elastic bandages to the legs. 

JANUARY 1967 



Effectiveness of nursing visits 
to primigravida mothers 



On testing the hypotheses that primigravida mothers who had public health 
nursing visits during and at the end of their first four weeks at home would have 
fewer, and less intense, concerns about infant care than mothers who did not 
receive visits, the author reached some surprising conclusions. 



Louise S. Brown, B.Sc.N., M.S.N. 



The purpose of this project was to 
study the effects of public health 
nursing visits on the concerns of the 
young primigravida mother with her 
first baby. Two groups of mothers 
were used: one group had public health 
nursing visits, and the second group 
had no visits by a public health nurse. 
The concerns of the mothers in the 
study were assessed at two time in 
tervals: once during the mother s stay 
in hospital, and again after she had 
been at home with her infant for four 
weeks. 

Need for the study 

The increasing demands for service 
from the other program areas of pub 
lic health nursing have focused atten 
tion on the traditional maternal and 
child health services of the public 
health agencies. Public health nurses 
are faced with the dilemma of con 
tinuing with an established educational 
program or of abandoning it in favor 
of the pressing needs to provide new 
home care programs or rehabilitative 
services. 

Two arguments are most frequently 
used for either changing or maintain- 

Miss Brown, a 1965 CNF Scholar, is a 
lecturer at the University of Western Ontario 
School of Nursing, London, Ontario. She 
based this article on a project completed 
in 1965 as partial requirement for her 
M.S.N. degree at Western Reserve Univer 
sity, Cleveland, Ohio. The complete thesis 
has been deposited in the CNA library. 
JANUARY 1967 



ing the nursing service. One is that 
the mother of today receives all the 
help she needs from her family physi 
cian and from the body of knowledge 
she has acquired through her reading 
and general education. The public 
health nurse, therefore, would spend 
her time more profitably by limiting 
her visits to those families who either 
have requested her visits or who have 
obvious health needs. This means 
that routine visits to all postpartum 
mothers should be eliminated and 
only visits on a priority basis be under 
taken by the public health nurse. 

The other point of view is that the 
maternal and child health program is 
the basis of a public health nursing 
service, and through it many beginning 
health problems are discovered. It is 
in this early mother-child relationship 
that the foundations are laid for the 
child s future development and health. 1 
The public health nurse is most help 
ful by providing assistance to the 
mother in understanding her child s 
growth and development and her new 
role as a mother. To do this effective 
ly, she needs to visit the homes of all 
new parents to assess how she can 
help these expanding families. While 
assisting the young parent, the public 
health nurse also achieves two of the 
basis tenets of a public health service: 
the promotion of health, and the pre 
vention of disease. 

The Expert Committee of the World 
Health Organization states that a pro 
gram of health services will be effective 



if it is built on the needs of the people 
served. 2 The public health nursing 
programs must meet the same cri 
terion. Research is needed to determine 
the needs of the mother and the effect 
of public health nursing visits on these 
needs. Until this kind of information 
is available, there is no scientific evi 
dence to support either of the two 
previously stated points of view, that 
is, to limit or to expand the public 
health nursing program in maternal 
and child health. 

The investigator developed the fol 
lowing research design to discover the 
concerns of the new mother and the 
effect of public health nursing visits 
on her concerns. 

Review of the literature 

No literature is available on the ef 
fectiveness of public health nursing vis 
its to the primigravida mother. There 
are, in fact, only a few studies 3 * 5 8> 7 
that discuss the public health nursing 
programs in the area of the mother 
and her infant.* These studies have 
assessed the existing services in ma 
ternal and child health at prenatal 
classes child health centers, and in 
home visits. Of the studies, only those 

* Since this study was completed, another 
study by Dr. H. Carpenter has been publish 
ed: The Need for Assistance of Mothers 
with Their First Babies During the Three- 
Month Period Following the Baby s Birth. 
Toronto, Univ. of Toronto, School of Nurs 
ing, Alumni Assoc., 1965. 

THE CANADIAN NURSE 45 



done by Hunter and Carpenter 4 :t 
focus upon the help the public health 
nurse provides in her home visits to 
the mother with her newborn infant. 
A study done by Adams, 8 while not 
discusing the role of the public health 
nurse, explores in detail the "early 
concerns" of the primigravida mother 
about the care of her infant during 
the first four weeks at home. 

Hunter s study analyzes the routine 
visits made by public health nurses in 
a large city to all newborn infants. 
The method of study is to ask the 
public health nurse to complete a 
questionnaire following each of 10 
visits to a mother and her newborn 
infant. The result is an interpreta 
tion of the value of the service by 
the participating public health nurses. 
Eighty-one percent of the nursing visits 
are judged to be valuable. The study 
concludes that the service is meeting 
a need but that the need has changed. 
The physical needs of the infant have 
become less of a problem to the mother 
since, in most cases, the mother is 
able to handle this herself. The new 
needs are reported to be: the mother s 
feeling toward her baby, her own 
problems, and problems in family 
dynamics. 4 

Carpenter s study is an analysis of 
home visits by the public health nurse 
to mothers of newborn infants resid 
ing within the area of a health unit. 
The home visits are analyzed through 
the use of tape recorders and ob 
servers. It is found that of the 38 
mothers of first children, 20 asked 
the nurses about the normal growth 
and development of their children. 3 
What these questions are, and how 
the public health nurse assisted the 
mothers in finding the answers is not 
reported.** Because of the anxiety 
expressed to the nurses and the reports 
made by the observers, Carpenter re 
commends in her study that the mother 
with her first baby should be given 
priority upon public health nursing 
time. She recommends, also, that to 
be most useful, this service should be 
available as soon as possible after the 
mother s return home from hospital. 3 

The third study by Adams is an 
exploratory one to determine: 1. the 
concerns of the primigravida mother 
in caring for her infant; 2. how these 
change over a period of time; and, 
3. whether or not they are related to 
the infant s birthweight. The samples 
used are 20 primigravida mothers of 

** Carpenter s second study of the need 
for assistance of mothers with first babies 
identifies many concerns about infant care. 
Most of these concerns are used by this 
investigator in developing the tool for as 
sessing the effects of public health nursing. 
46 THE CANADIAN NURSE 



infants of normal birthweight and 20 
primigravida mothers of infants of 
premature birthweight. The 40 mothers 
are interviewed at three time periods 
throughout the first month of infant 
care, once in the hospital and twice 
at home. Five areas of worries are 
described: feeding, bathing, crying, 
care of the navel, and/or circumcision, 
and other. Feeding is the major con 
cern for all mothers throughout the 
month. "Other concerns" rank second, 
and crying is third. Birthweight does 
not influence the results of the study. N 

Ft is further stated that the early 
days of care in the hospital and at 
home may be times of "special needs" 
for new mothers. Mothers of infants 
of premature weight in the study rely 
on nurses in helping to care for their 
newborn infants. Mothers of children 
of normal birthweight use their family 
and friends to help them. It is not 
reported whether or not public health 
nursing visits were made to all the 
mothers in the study. A recommenda 
tion made in this study is that a nurse 
working closely with the physician 
could answer the mother s questions 
and convey information to him about 
the mother s progress in caring for 
her infant. 8 

In summary, the studies by Hunter 
and Carpenter approach the public 
health nursing services through the 
public health nurse. No attempt is 
made to ascertain from the mother 
what her concerns are in regard to 
infant care.j The study by Adams, 
on the other hand, concentrates on the 
mother s concerns, but there is no evi 
dence that the effect of the public 
health nurse is considered. 

Because of the lack of literature 
about the effect of public health nurs 
ing visits on the fears of mothers in 
caring for their infants, the following 
research project was developed to 
examine it. The design combines the 
studies done by the aforementioned 
investigators, the effects of the public 
health nursing service, and the con 
cerns of the mother about infant care. 

The primigravida mother is begin 
ning her experience as a mother and 
will not have learned to adjust to the 
problems of child care, while the 
mother with other children has learned 
how to care for infants and has an 
established pattern of child-rearing 
methods. The primigravida mother has 
many problems associated with infant 
care as demonstrated by Adams study. 
She seems to want help as indicated 
bv Hunter and Carpenter. The mother 
with her first-born child was selected 

| In the second study by Carpenter, infor 
mation is obtained from the mothers to as 
certain their needs. 



for this project because of the above 
observations. The study by Adams 
was of considerable value in defining 
terms and in the construction of the 
instrument used in this study. 

Hypotheses tested 

For the purpose of this study, the 
following hypotheses were tested: 

1. Primigravida mothers who have 
public health nursing visits will have 
significantly fewer concerns about the 
care of their infants than mothers 
who do not have public health nurs 
ing visits during the first four weeks 
they are at home with their infants. 

2. Primigravida mothers who have 
public health nursing visits will have 
a significantly greater reduction in the 
intensity of the concerns that still re 
main at the end of the four weeks at 
home than those mothers who do not 
have public health nursing visits. 

Terminology 

Primigravida mother as used in this 
study is a woman who has given birth 
to her first child and who has never 
lost a previous pregnancy. 

A concern is any aspect of infant 
care that worries a new mother. 

Intensity of concern is the degree 
of the concern as judged by the mother 
on a scale ranging from no concern to 
extremely concerned. 

Newborn infant is any infant born 
to the mothers in the sample who are 
of normal birthweight and are without 
any physical defects. 

Public health nursing visits are visits 
made by a nurse employed by a volun 
tary or an official health agency to 
the primigravida mother in her home. 

Methodology 

The mothers in this study were 
drawn from the regular admissions to 
the maternity wards of primigravida 
mothers after their delivery. Their se 
lections was made according to the fol 
lowing criteria: 

1. The mother is 20 to 29 years 
of age inclusive. 

2. The pregnancy is without recog 
nized complications. 

3. The mother does not have an as 
sociated illness and is well and able 
to care for her infant. 

4. The mother has delivered a normal 
infant of normal birthweight and with 
no physical defects. 

5. The mother and her child are 
under the care and supervision of a 
family physician. 

6. The mother is married and living 
with her husband. 

7. The husband is currently employed 
or has a means of income not con 
sidered to be welfare. 

Two hospitals were used in the 
JANUARY 1967 



I 




JANUARY 1967 



study and the first 20 mothers who 
met the criteria from each hospital 
were designated as Group A and 
Group B respectively. Group A moth 
ers had visits from a public health 
nurse and Group B mothers did not 
have public health nursing visits. 

The sample mothers were contacted 
twice: on the third or fouth day post- 
partum in hospital, and after they had 
been at home caring for their infants 
for four weeks. At both of these times 
the mother was asked to complete the 
same questionnaire about infant care. 
In hospital the mothers were contacted 
personally by the investigator. The 
second contact was made by mail. 

The instrument used in the study 
was a questionnaire developed by the 
investigator from her personal exper 
iences as a public health nurse and 
from writings on child care, especially 
the article by Adams. 8 It attempted 
to assess the level and intensity of the 
mother s concerns about infant care in 
the following broad areas: bathing, 
crying, feeding, elimination, routine 
care, and sleeping. Three of these 
areas, feeding, crying, and bathing, 
were found by Adams to be problems 
for the mothers. 

The mothers were also asked to 
rank the six areas of infant care in 
order of their importance to them and, 
after four weeks, to indicate the three 
most helpful persons to them during 
the past four weeks, and the number 
of physician contacts they had made. 
Identifying data about the mothers 
were taken as well as some indication 
of their knowledge and experience in 
child care. 

The chi-square test was used to 
support or reject hypothesis one. The 
test for hypothesis two was the Mann- 
Whitney U-test. Any differences oc 
curring beyond the 5 percent level of 
chance were considered significant in 
applying these tests. 

The findings 

Forty primigravida mothers were in 
the sample and all 40 mothers return 
ed the first questionnaire. All but one 
returned the second questionnaire. 
This mother was in the group with 
public health nursing visits. 

The tests revealed that for this study 
the two groups of mothers could be 
considered to be from the same popu 
lation except for the level of educa 
tion and the number of mothers who 
worked following their marriages. The 
non-service group of mothers had a 
higher educational level, worked less 
frequently following their marriages, 
and tended to have more help at home 
with their infants. The control group 
of mothers lived in a geographically 
different community from the mothers 
THE CANADIAN NURSE 47 



with public health nursing service. No 
attempt was made to assess the socio- 
economic levels of the parents. The 
mothers in Group B probably had 
an advantage here as well, since educa 
tion is one indicator of this status. 

Hypothesis One 

In general, sample A mothers in 
dicated more concerns at time one in 
all areas of infant care except crying. 
This group had more "not stated" re 
sponses than Group B. At time two, 
the same trends continued with one 
exception. The test mothers also re 
ported fewer concerns than the control 
group about feeding their infants. 

Bathing: Both groups showed a re 
duced number of concerns about bath 
ing their infants from time one to time 
two. Although these results were great 
er for the mothers with nursing care, 
the difference was not significant and 
hypothesis one was not supported. 

Crying: The number of concerns 
about the crying of the infants was 
significantly reduced for each group 
after four weeks. The results, how 
ever, did not indicate a significant 
enough difference between the two 
groups to support hypothesis one for 
crying. 

Feeding: At time one, the mothers 
in sample A had significantly more 
concerns about the feeding of their 
infants. At time two, there was a sig 
nificant reduction in the concerns of 
the primigravidas with nursing care, 
while the mothers without this help 
did not achieve this. Hypothesis one 
was supported for feeding. 

Elimination: No real difference was 
indicated for either group of mothers 
after four weeks of caring for their 
children. Hypothesis one was not sup 
ported for the primigravida mother s 
concern about her infant s elimination. 

Routine care: Although each group 
of mothers was able to reduce her 
concerns about the routines of infant 
care significantly from the time in 
hospital, the difference between the 
groups after four weeks was not ade 
quate to support the hypothesis. 

Sleeping: The control mothers show 
ed significantly fewer concerns about 
the sleeping habits of their infants 
than the mothers with nursing care 
at both times. The change in the num 
ber of concerns from time one to time 
two, however, was not significant 
enough between the groups to support 
the hypothesis. 

Hypothesis Two 

In general, at time one in hospital, 
the scores of the intensity of the con 
cerns about all areas of infant care 
were higher for those primigravidas 
who had public health nursing visits. 

48 THE CANADIAN NURSE 



At time two, the total scores for each 
concern was reduced except for sam 
ple B in the area of sleeping. This 
score was elevated at time two. 

Bathing: Both groups of mothers 
showed a reduction in the intensity of 
their concerns in this area to well 
below the level of chance over the 
four- week period. The difference be 
tween the groups, however, was not 
sufficient to support hypothesis two 
for bathing. 

Crying: After four weeks at home, 
the mothers in sample A had not 
shown a significant reduction in the 
intensity of their concerns over their 
infants crying. This, however, did not 
hold for the mothers without nursing 
care. The results obtained were very 
significant and in the opposite direc 
tion to that proposed by the researcher. 
Feeding: The in- hospital data col 
lected from the mothers were signifi 
cant for the mothers in the test group. 
These mothers had a much higher 
intensity score about the feeding of 
their infants. After four weeks they 
were able to reduce this score to a 
level of probability of less than .005. 
Group B, on the other hand, had no 
significant change in either direction. 
Hypothesis number two was accepted. 
Elimination, routine care, and sleep 
ing: The null hypothesis was accepted 
for these three areas. No statistically 
significant data were obtained and 
hypothesis two was -not supported. 
Public health nursing visits made no 
appreciable difference in the intensity 
of the mothers concerns about the 
elimination, routine care, or the sleep 
ing of their infants. 

For both groups of mothers at the 
two times, crying ranked first and 
feeding second. There was some shift 
ing of the other four areas at the two 
times tested, and the differences ob 
tained are questionable as to prefer 
ence over another concern. 

A difference also appears in com 
paring the ranks of the mothers in this 
study with areas of concern as found 
by Adams. 8 The sample as a whole 
placed crying first and feeding second. 
In Adams study, the reverse was 
found. Primigravida mothers with and 
without nursing service listed their 
husbands first and their mothers sec 
ond in terms of helpfulness to them 
over the four-week period. The third 
most helpful person for group A moth 
ers was the public health nurse. She 
was ranked first by three of eight pri 
migravidas in the sample. 

In all cases, it was the mother who 
was visited by the nurse from the 
voluntary agency who indicated the 
nurse as helpful. In one unsolicited 
response, however, a mother who was 
visited by a nurse from the official 



agency wrote in the following state 
ment at the end of a lengthy note 
about her infant s crying: "I found that 
if for nothing else it helps to talk with 
the public health nurse because it reas 
sures you and you can ask about small 
worries without having to disturb your 
doctor." 

In third place for Group B mothers 
was a variety of other family mem 
bers. The physician was placed fifth 
by both groups. 

The number of physician contacts 
also varied for each group. The moth 
ers with nursing visits had an average 
of 2.5 physician visits, while the 
mothers without nursing had an aver 
age of 2.0 visits. 

Two mothers from sample A and 
three mothers from sample B had no 
contact with their physicians during 
the period of the study. The maximum 
number was five contacts made by 
two primigravida mothers in Group A. 
One mother in Group B had as many 
as 10 contacts with her physician dur 
ing the study period. 

Discussion and conclusion 

The long term purpose of this study 
was to find objective evidence to use 
in the following controversy in public 
health nursing programs: the contin 
uance of a maternal and child health 
program as opposed to the curtailment 
of this service in favor of newer pro 
grams in other areas. The literature 
available to the investigator was limit 
ed and none of the reports attempted 
to compare two groups of primigravida 
mothers one with nursing care and 
one without - - to clarify the effects 
of public health nursing services. The 
results of the present study do not 
strongly support either of the two 
arguments. In spite of limitations in 
its sampling, the data do point out 
pertinent directions for further study 
of the controversy. 

The major findings of this study 
were: The public health nurses had a 
positive effect upon both the number 
and intensity of the primigravida moth 
er s concerns about the feeding of her 
infant. A second major finding was in 
the opposite direction than predicted 
by the investigator. Although no differ 
ence was found with the group of moth 
ers who had public health nursing care 
for numbers of concerns about crying, 
the primigravida mothers who did not 
have visiting nurses had a greater re 
duction in the intensity of their con 
cerns about their infant s crying. 

In comparing the changes that oc 
curred within each group over the 
four weeks for the total sample, there 
was no reduction made in either the 
number or the intensity of concerns 
about the infant s sleeping. Bathing 
JANUARY 1967 



concerns were reduced both in num 
ber and intensity for all primigravidas. 
No reduction in the intensity of the 
concerns for elimination and feeding 
was evident, although the numbers of 
these concerns were reduced for all 
primigravidas over the four weeks. 

The findings relating to feeding and 
crying suggest that the effects of pub 
lic health nursing visits require further 
study. Why do mothers without nurs 
ing care have reduced intensity of con 
cerns about crying? Why does the pub 
lic health nurse produce improvement 
in the mother s concerns only in the 
area of feeding? Answers may be with 
the quality of an instrument to assess 
these areas accurately and it may also 
be in the quality of the nursing service 
given. Such questions could be answer 
ed by further study using three groups 
of mothers: one without public health 
nursing, one with the usual public 
health nursing, and a third group of 
mothers given excellence in nursing 
care by a select group of nurses with 
controlled supervision. 

Another factor that influences the 
number and intensity of concerns lies 
with the mothers and cannot be con 
trolled. The mother, in hospital before 
she has had any experience with her 
own infant, seems unable to assess ac 
curately what areas will be of concern 
to her and how much of a concern. 
Some areas that are not problems in 
hospital become major problems as 
the child grows. Other concerns disap 
pear completely as the new mother 
benefits from her experience. All the 
mothers in the sample ranked crying 
as number one and feeding as number 
two while in hospital, and later after 
four weeks. Adams also found crying 
of major importance but it was second 
to feeding. 8 In that study, however, 
no public health nursing services were 
available and half of the mothers gave 
birth to premature children. 

The results in the present study are 
ambiguous. Feeding was positively im 
proved for the mothers with nursing 
service. Still, these mothers ranked 
feeding second as did the non-service 
mothers. Crying was reduced in in 
tensity for non-service mothers, yet 
they continued to rank it first as did 
the mothers with nursing service. The 
limitation in the study s sampling ap 
pears to have some influence on this. 
A possible cultural variation in what 
is seen as a concern appeared between 
the two groups before the mothers had 
any experience with their children. 
Some of the non-service group of 
mothers also had "extended visits" 
with their infants in hospital plus ad 
ditional help in the home, which may 
have influenced their interpretation 
and intensity of concerns. 

JANUARY 1967 



A very important finding in this 
study results from the ranking of in 
dividuals in terms of "helpfulness." 
There is, in fact, a need to clarify this 
whole area. Mothers in the entire sam 
ple ranked their husbands first and 
their mothers second in helpfulness. 
Those mothers with public health nurs 
ing services ranked the nurse third, 
while the non-public health nursing 
group ranked other family members 
third. The question of how a mother 
views help is not answered in this 
study. It is observed, however, that the 
primigravida s husband and mother are 
with her throughout the 24-hour pe 
riod, and undoubtedly give assistance 
in the care of the baby and home. 

Physician services were used differ 
ently by the two groups. The mothers 
with public health nursing care con 
tacted their physicians more often and 
only two in the group were in touch 
with him as many as five times. On 
the other hand, those primigravida 
mothers without service reported con 
tacting their physicians less often. One 
mother, however, stated that she con 
tacted her physician 10 times in the 
four weeks. The investigator believes 
that the mothers with nursing care 
used their physician services more 
wisely than the mothers without care. 
Before this conclusion can be made, 
however, further study of this whole 
area of "helpfulness" and what per 
sons are "helpful" is needed. 

As stated previously, more work is 
needed to improve the sensitivity of 
the study s instrument and its ability 
to discriminate differences. The weight 
assigned by the mother was not ac 
curately assessed. One mother ranked 
feeding first, but in ranking the scores 
for her, crying was first and feeding 
further down the list. In reviewing her 
responses, it is observed that she had 
fewer concerns about feeding and that 
only one of these did she rate high in 
intensity. This aspect concerned the 
amount of breast milk the baby should 
get. Clearly, the mother ranked this 
above all others. Before using this ins 
trument in further studies, all non-dis 
criminating items need to be removed. 

Summary 

The results of this study clearly 
point to a revision of the instrument 
and further study of the concerns of 
primigravida mothers. The addition of 
a third group of mothers who receive 
skilled public health nursing care 
under controlled supervision, plus the 
opportunity of rooming-in with their 
infants in hospital, is also indicated. 
An additional study is the whole area 
of "helpfulness"; how a mother in 
terprets help; whom she sees as help 
ful persons; and what they contribute. 



References 

1. Morris, Marian G. The claiming-identi- 
fication processes -- their meaning for 
mother-child mental health. Amer. J. 
Orthopsychiat. 25: 303-4, 1965. 

2. World Health Organization. Expert Com 
mittee on Nursing. Technical Report 
Series, no. 167. Geneva, 1959. 

3. Carpenter, H. et al. An Analysis of Home 
Visits to Newborn Infants. Toronto, East 
York Leaside Health Unit, 1960. 

4. Hunter, T. et al. Routine home visits to 
newborn infants by public health nurses. 
Canad. J. Public Health 53: 371-376, 
1962. 

5. Mann, D. et al. Educating Expectant 
Parents. New York, V.N.A. of New 
York, 1961. 

6. Martin, O.K. and Ladd, K.B. Maternal 
and child services, Ontario, 1958. Canad. 
J. Public Health 51: 111-119, 1960. 

7. Shyne, A.W. et al. Serving the Maternity 
Patient Through Family-Centered Public 
Health Nursing. New York, Community 
Service Society of New York, 1962. 

8. Adams, Martha. Early concerns of pri 
migravida mothers regarding infant care 
activities. Nurs. Res. 12: 72-77, 1963. 

9. Seigel, S. Nonparametric Statistics For 
the Behavioral Sciences. New York, 
McGraw-Hill, 1956. 



THE CANADIAN NURSE 49 



Project bed rest 



Six enterprising students at the Calgary General Hospital School of Nursing 
conceived, designed and launched a unique plan to make nursing care for the 
medical patient more consistent. 



L. Dahl, M. Smith, B. Fowle, J. Hutchison, R. Graham, and D. Black 



"Project Bed Rest" originated in 
June 1965 during discussion periods 
in our medical nursing clinics. As in 
termediate students we were concerned 
about the how, when, what, and why 
of health teaching. We agreed that 
when teaching medical patients our 
emphasis should be on both rest and 
activity. 

First of all we considered the mean 
ing of "rest" and other terms used to 
describe rest and activity for patients. 
As each of us interpreted "complete 
bed rest" and "bed rest," we realized 
that there was considerable difference 
of opinion regarding what instruction 
should be given to patients. If a similar 
confusion of terms existed in the minds 
of doctors, nurses, auxiliary workers, 
and patients, how inconsistent the nurs 
ing care must be! 

We decided that if guide lines for 
teaching medical patients could be es 
tablished, this problem might be solv 
ed. With the help of two of our medical 
nursing instructors, we drew up a plan 
to study the whole subject of rest, to 
define the terms "complete bed rest" 
and "bed rest," and to gain approval 
of the appropriate groups in the hos 
pital. Thus, project bed rest was 
launched with an overall objective to 
provide more consistent nursing care 
for medical patients. 

The first task was to clarify the 
purposes of the project. These were: 

1. To provide consistent care re 
garding rest and activity throughout the 

50 THE CANADIAN NURSE 



patient s period of hospitalization. 

2. To help the patient understand 
his program of care, participate in it 
and see his progress. 

3. To improve communication 
among doctors, nurses, other staff, pa 
tients, and patients relatives. 

4. To aid in the orientation of nurs 
ing students, new graduates, and other 
staff. 

5. To aid in the teaching of new 
nursing students in the nursing arts 
program. 

The second step in the project was to 
define and clarify the terms relating to 
rest and activity, namely: 1 . complete 
bed rest; 2. bed rest; and 3. progres 
sive activity. 

Steps to obtain approval 

To obtain approval for the accept 
ance and implementation of project 
bed rest, many steps were involved. At 
each level of approval the purposes 
and specific definitions of the project 
were presented in detail. We empha 
sized that staff would not be expected 
to adhere rigidly to the definitions but, 
rather, that each section could serve as 
a guide for all personnel on the health 
team. Alterations as specified by the 
doctor might be required for individual 
patients. 

Since the project was initiated by 
nursing students, the first step was to 
gain the approval of the faculty of 
the school of nursing. The plan for 
rest and activity was presented at a 



faculty meeting. With some minor re 
visions, it was unanimously and en 
thusiastically endorsed. The faculty 
suggested that the plan be utilized in 
all clinical areas of the hospital. 

Next, the revised plan was presented 
to the director of nursing service, 
supervisors, and head nurses at a staff 
meeting. Also present at this meeting 
was a consultant cardiologist who had 
expressed interest in project bed rest 
and had offered helpful suggestions, 
especially in defining progressive acti 
vity. Again, the plan was readily ac 
cepted and approved for all clinical 
areas. 

Having received support from the 
faculty and all nursing service person 
nel, we next sought the approval of the 
hospital administrator. He reviewed 
the plan several times and made some 
very helpful suggestions. 

The final step was to present the 
plan to the medical advisory com 
mittee. The administrator explained the 
proposed plan to the committee, and 
its members gave us enthusiastic sup 
port and approval. 

Implementation 

Project bed rest was now ready 
to be implemented. The responsibility 
for making the plan operational was 
accepted by a nursing service commit 
tee under the chairmanship of a head 
nurse. The written material was dis 
tributed to all nursing units and to 
staff doctors. Individual copies of the 
JANUARY 1967 




particular phase or phases of rest 
ordered were given to patients with 
verbal explanations. All groups con 
cerned with the project recognized that 
the guide lines would have to be inter 
preted to new staff, as well as to in 
coming patients, if project bed rest 
were to be successful. D 



Complete Bed Rest 

1. To stay in bed at all times. 

2. a. To be fed. 

b. To restrict movements. 

3. To be bathed every second day or p.r.n. (minimal 
linen change) 

To have total mouth care after meals. 

To have hair shampoo once per week, if ordered, in 

bed. 

4. To be shaved. 

To have cosmetics applied, if desired. 

5. To have half-hour rest periods between 2, 3, and 4 
above. 

6. To be turned q.2h. as tolerated, and raised up in bed 
by staff (lifting sheet required, e.g., sheepskin). 

7. To have passive movements b.i.d. to all joints for 5 
minutes and deep breathing exercises q.lh. (10-12 deep 
breaths). Should wiggle toes, fingers, feet, wrists, q. Ih. 

8. To have visitors restricted to immediate family (5 min.), 
one at a time. 

9. To use bedpan (slipper pan); should be assisted by two 
people. Males to use urinaj in bed. 

10. a. To have reading material propped, 
b. To operate radio. 

11. To have a "call" light within easy reach at all times. 

12. To be checked at regular intervals by the nurse. 



Bed Rest 

1 . To stay in bed at all times, except for use of commode 
chair. 

2. To feed self; food must be set up, e.g., meat cut, bread 
buttered, etc. 

3. To be bathed, but may wash face, hands and finish 
bath. 

To remain in bed while linen is changed. 
To give self total mouth care after meals. 
To have shampoo weekly, if ordered, in bed. 

4. To shave self. 

To apply own cosmetics. 

5. To have half-hour rest periods between 2, 3, and 4 
above. 

6. To turn self by rolling from side to side like a log; 
must be assisted when raising up in bed. 

7. To initiate active movements b.i.d. to all joints, for 5- 
minute periods. 

To take deep breathing exercises qlh. 

8. To have visitors restricted to immediate family (15 
min.). 

9 To be lifted into commode chair at bedside for bowel 
movements. 

10. a. To hold books, etc. 

b. To operate radio nd T.V. 

11. To have a "call" light within easy reach at all times. 

12. To be checked at regular intervals by the nurse. 



JANUARY 1967 



THE CANADIAN NURSE 51 



Progressive Activity 



Day Bath every 2 days 
or p.r.n. 



Elimination 



Sitting 



Walking 



1 With help. Legs, feet, and 
back to be done by nurse 

2 With help 



3 With help 



4 With help 

5 With help 

6 May bathe self in bed. 
Shampoo if ordered. 

7 May bathe self in bed. 
Shampoo if ordered. 

8 May bathe self in bed. 
Shampoo if ordered. 



9 May bathe self in bed. 
Shampoo if ordered. 

10 May bathe self in bed. 
Shampoo if ordered. 

1 1 Wash self in bath-room. 



12 Wash self in bath-room. 



Commode at bedside for BM s 

(lifted). 
Use bedpan, urinal for voiding. 

Commode at bedside for BM s 

(lifted). 
Use bedpan, urinal for voiding. 

Commode at bedside for BM s 

(lifted). 
Use bedpan, urinal for voiding. 

Commode in BR for BM s, use 
bedpan or urinal for voiding. 

Commode in BR for BM s, use 
bedpan or urinal for voiding. 

Commode in BR for everything. 
Commode in BR for everything. 

May walk to bathroom once 

daily. 
Commode in bathroom other 

times. 

May walk to bathroom twice 

daily. 
Commode other times. 

May walk bathroom three times 
daily, commode other times. 

See "walking." 



Dangle 5 min. b.i.d. 



5 min., chair at bedside (lifted). 



5 min., b.i.d., chair near bed 
side (self-assisted). 

10 min., b.i.d., chair near bed 
side (self-assisted). 

15 min., b.i.d., chair near bed 
side (self-assisted). 

20 min., b.i.d., chair near bed 
side (see "walking"). 

25 min., b.i.d., chair in room. 



30 min., b.i.d., chair in room. 

35 min., b.i.d., chair in room. 

40 min., b.i.d. 
45 min., b.i.d. 
Increase chair 5 min. daily. 



Nil 



Nil 



Nil 



Nil 



Nil 

2 or 3 steps to chair b.i.d. (as 
sisted). 

5 or 6 steps to chair (assisted). 



Walk to chair b.i.d. and walk 
to bathroom once daily (if 
BR within 10 yards of bed). 

Walk to bathroom twice daily. 



Walk to bathroom three times 
daily. 

Walk to bathroom four times 
daily. 

Increase walk to bathroom once 
daily then walk in corridor and 
up and down stairs as ordered. 



52 THE CANADIAN NURSE 



JANUARY 1967 



books 



Pediatric Nursing by Audrey J. Kalafatich, 
R.N., M.S.N. 432 pages. New York, 
G.P. Putnam s Sons, 1966. 
Reviewed by Miss Nell Joiner, assistant 
professor, maternal-child nursing, Me 
morial University of Newfoundland 
School of Nursing, St. John s, Nfld. 

The author states in the preface that her 
aim is to give some insight into the care 
of the "whole child." The format of the 
text follows the usual sequence of delineat 
ing care of the child from birth through 
adolescence according to developmental 
tasks and needs peculiar to specific develop 
mental levels. Throughout the text, brief 
reference is made to common diseases and 
disorders according to age levels, with treat 
ment and nursing care following each condi 
tion. General principles of nursing care are 
outlined but never developed in breadth and 
depth. 

Unit I is extraordinarily brief and 
vague in presenting a frame of reference 
for quality nursing care based on un 
derstanding of the child as a person in a 
given point of time with a specific problem 
and as a member of a family constellation. 
The reference to the importance of relation 
ships and interrelationships in pediatrics 
follows the same generalization. It would 
have been better to omit this entirely rather 
than to confuse the issue with superficiality 
and vagueness. 

Units II through VI deal with the cycle 
of childhood from birth through adoles 
cence. The discussions of treatment and nur 
sing care seem more of a condensed resume 
with sweeping generalizations, rather than 
broad principles upon which to base and 
plan individualized nursing care. I find the 
discussions that are devoted to nursing care 
disappointingly brief and inadequate. An 
example of this brevity appears on page 
218, where the author devotes a three- 
sentence paragraph to the treatment and 
care of the infant with cerebral palsy. 

Another example of brevity appears on 
page 413: "The pre- and postoperative care 
that accompanies the spinal fusion will not 
be given in detail since it is essentially the 
same as for an adult patient with a solid 
fusion of the spine." By a swift stroke of a 
pen, the author moves to something else 
without pointing out the similarities and 
differences. It would seem that she is as 
suming that the student has sufficient prior 
knowledge and experience to make the 
necessary adaptations in planning care for 
the adolescent with a spinal fusion. 
JANUARY 1967 



Some of the information on treatment 
and nursing care is unclear and, consequent 
ly, open to misinterpretation. An example 
of lack of clarity appears on page ISO in 
which the author states that "an elevated 
temperature raises the body s need for oxy 
gen and metabolism." Here she treats an 
adaptive bodily process, metabolism, in the 
same order as the body s need for a life- 
sustaining substance, oxygen. What is she 
trying to convey the body s reaction to 
an elevated temperature, the increased need 
for oxygen to meet the demands of speeded 
up cellular activity, or what ? 

This book falls far short of presenting 
any real insight into the care of the "whole 
child" and does not support the thesis that 
the book is primarily concerned with nur 
sing care. Brevity, sweeping generalizations, 
and vagueness are its chief characterictics 
and weaknesses. It may have some value 
as a handbook for quick, brief references, 
but limited value as the text of choice for 
basic students in professional nursing. 

Fundamentals of Research in Nursing 

by David J. Fox, Ph.D. 285 pages. New 
York, Appleton-Century-Crofts, 1966. 
Reviewed by Miss Kathleen A. Dier, as 
sistant professor, School of Nursing, Uni 
versity of Saskatchewan, Saskatoon, 
Saskatchewan. 

The stated purpose of this book is to 
prepare the nurse to be an "intelligent, criti 
cal consumer of research." The author ex 
plains that the skills needed to understand 
and use research are different than those 
needed to do research. It is intended to 
help nurses evaluate the research now being 
produced, not only in nursing but in relat 
ed social sciences as well. Dr. Fox is well 
prepared for this assignment as he teaches 
an introductory course in nursing research 
at Columbia University, New York. 

The book is divided into five major areas. 
The author begins by describing a project 
that he conducted, then deals in detail 
with the 17 steps required in the planning 
and implementing of this study. He proposes 
a model that should help identify areas for 
further research in nursing. It is stated that 
nurses have a unique contribution to make, 
providing they concentrate on problems 
related to nursing. However, Dr. Fox is 
also in favor of interdisciplinary research 
where the nurse is a member of the investi 
gating team. 

The second area is mainly devoted to 



statistical procedures that the author believes 
must be comprehended before the principles 
of research can be understood. The rationale 
of statistics is given without any of the com 
plicated formulae. Even though this section 
is clearly written with practical examples 
taken from nursing, some of the concepts 
might be hard to grasp if the reader has 
no previous knowledge of statistical 
methods. The section on sampling is excel 
lent. 

The fourth area deals with the various 
types of research and the methods of 
gathering data. Here, the issue of ethics 
in nursing research is raised and I would 
heartily agree that this is a problem that 
must be faced soon by our profession. 

In the fifth section, the nurse is advised 
how to evaluate the written report. It is 
truly stated that where research is concerned 
nurses have been "a polite, uncritical and 
largely unresponsive audience." Dr. Fox 
urges nurses to make more use of good 
research findings and actively reject those 
that are poor. This is the only way that the 
product will be improved. 

I believe the author has achieved his 
objective by presenting rather complex 
research methodology in a simple, straight 
forward manner. It could be a valuable 
reference for leaders in nursing and students 
in university, since it contains many ideas 
for nursing studies and an excellent reading 
list. Although it is not light reading, I 
would recommend this book to all nurses 
who wish to become intelligent participators 
in the changes now taking place in our pro 
fession. 

Basic Concepts in Anatomy and Physiology 

by Catherine Parker Anthony, R.N., B.A., 
M.S. 132 pages. Saint Louis, Mosby, 1966. 
Reviewed by Mrs. Jean Magee, instructor 
of anatomy and physiology, Victoria 
General Hospital School of Nursing, 
Halifax, Nova Scotia. 

To review this book objectively, I had to 
supplement my knowledge of programmed 
instruction. In so doing, I reversed a rather 
unfavorable first opinion to one of great 
enthusiasm. 

The author has achieved her expressed 

purpose to produce a programmed text that 

would be used as a "supplement and not 

as a substitute for a conventional textbook." 

She states in the preface that "the book 

will have greatest value for students wanting 

to acquire or review basic information or to 

(Continued on page 54) 

THE CANADIAN NURSE 53 



mi 
w 



Tfl 
JL 




says 

life at Mary Fletcher 
Hospital Medical Center 
is all work & no play? 

Uncrowded Vermont is for 
those who like outdoor fun. 
Sailing, swimming* skiing, 
tennis, golf, are only min- 
utes away from Mary Fh;t- 
cher Hospital on the shores 
of lovely Lake ChamprainX 
Combine an exciting carew 
with off-duty recreation andj 
the cultural advantages of] 
an attractive college com-J 
munity. Excellent starting 
salaries, liberal fringe bene 
fits, clinical affiliation with 
Univ. of Vermont College of 
Medicine. MFH serves as the 
primary teaching and refer 
ral center for all of northern 
New England. 
i 

Personnel Office, Dept. 401 

Mary Fletcher Hospital Medical Center 

Burlington, Vermont 05401 

Please tell me more about career opportuni 
ties at Mary Fletcher Hospital Medical Center 
and send me literature about Vermont 
The Beckoning Country. 

NAME 
ADDRESS 




IN CAPS AND GOWNS 

THE STORY OF 

THE SCHOOL FOR 

GRADUATE NURSES 

McGILL UNIVERSITY 
1920- 1964 

"... provides vignettes of the devoted 
and far-seeing women who toiled to 
develop the School . . . An amazing 
feature of this book is the warm and 
engaging style which emerges . . . A 
handsomely produced volume." 

THE MONTREAL STAR 



Available by mail or in person 

e/e 

SCHOOL FOR GRADUATE NURSES 

3506 University Street 
Montreal, P.Q. 

PRICE: $6.50 per copy 



books 



(Continued from page 53) 

clarify difficult concepts about the human 
body." 

Information in sequence is presented in 
small steps (frames) that require frequent 
responses by the student. Miss Anthony 
chose to use the classical linear form type 
of frame developed by Skinner at Harvard 
University, rather than the branching or 
multiple-choice frame. Early frames in each 
unit set forth simple, easy concepts of the 
subject material. 

If the reader chose only to read the begin 
ning questions in each unit, she would 
probably conclude that the entire book was 
too elementary for students of nursing. 
Questions in the early frames tend to be 
redefinitions of what has been previously 
stated, and a simple glance upward supplies 
the missing word. However, as the frames 
progress, there is also a step-by-step progres 
sion in the complexity of subject matter. 
The reader finds herself actively reading 
and responding to highly complex concepts 
without realizing their complexity. 

In this text, immediate feedback is given 
to the student to inform her whether her 
response is correct. The student need waste 
little time and effort confirming her res 
ponses as the correct answer is found to 
the left of each frame. Thus, if she answers 
correctly, she progresses to the next fact. 
If she does not understand, she can be 
helped immediately. 

In summary, this book will be a chal 
lenge to those who teach anatomy and 
physiology in schools of nursing. It could 
prove helpful as an aid to all students, in 
particular, to those students who have dif 
ficulty grasping principles in this subject. 



SPEND 72 MONTHS IN ENGLAND . . . 

A POST 

REGISTRATION 

COURSE 

leading to the 
OPHTHALMIC NURSING DIPLOMA 

at 
MANCHESTER ROYAL EYE HOSPITAL 

An interesting course at Britain s largest pro 
vincial Eye Hospital, part of the great Teach 
ing Hospital associated with the University of 
Manchester. 

Requirements Reciprocal registration with 
the General Nursing Council for England and 
Wales. 

Salary 57. 10s. Sterling per month 
5 weeks holiday with pay 

Attractive accommodation approx. 19 
Sterling per month 

Write for further details to: Miss N. Mustard, 
B.N. McGill, Matron, Manchester Royal Eye 
Hospital, Manchester 13, England. 



54 THE CANADIAN NURSE 



Elementary Textbook of Anatomy and Phys 
iology Applied to Nursing by Janet T.E. 
Riddle, R.G.N., R.F.N., O.N.C. 151 
pages. Toronto, MacMillan of Canada, 
1966. 

Reviewed by Sister Frances L. Rooney, 
assistant administrator, Holy Family Hos 
pital, Prince Albert, Sask. 

In spite of the brevity of this text, es 
pecially in the content about physiology, it 
is a very practical presentation, and should 
be of particular value to nursing assistants 
and technicians. Each system is presented 
concisely, and the book concludes with a 
valuable chapter on "Posture Nurse and 
Patient." 

The chapter on the digestive system is 
incomplete, but the chapter on the respir 
atory system is excellent. Accompanying 
illustrations are good. Anyone studying 
anatomy and physiology will find the review 
questions at the end of each chapter very 
practical, especially in reference to an 
atomy. 

This book is, as the author states, "a 
simple overall picture of the human body" 
and as such should be of value to a nurse 
looking for a quick review, or the beginning 
student who requires only very elementary 
knowledge of the subject. 

In Caps and Gowns by Barbara Logan 
Tunis, B.N. 154 pages. 1966. Montreal, 
McGill University Press. 
Reviewed by Miss Margaret E. Ken, Apt. 
1403, 150 -24th Street, West Vancouver, 
B.C., formerly executive director and 
editor of The Canadian Nurse. 

The significance and importance of uni 
versity education for professional nurses has 
been so strongly emphasized over the past 
few years that it is difficult to realize that 
50 years ago, even 40 years, it was practi 
cally an unknown quantity in Canada. Grad 
uates of the past two or three decades 
scarcely can imagine a time when Canadian 
universities, through their Boards of Gover 
nors, flatly refused to recognize the desire 
or the need for any programs for nurses. 
Today, the strong emphasis on advanced 
preparation is a keystone of policy in the 
Canadian Nurses Association. The findings 
of the Royal Commission on Health strength 
en the CNA platform. Why was nursing 
for so long an unwanted stepchild of higher 
education? 

This question and many others of a simi 
lar nature are answered in this history of 
the development of the School for Graduate 
Nurses of McGill University. Out of her 
very thorough research of old records, her 
interviews and correspondence, and her per 
sonal knowledge as a member of the first 
class to receive a B.N. degree from Mc 
Gill, Mrs. Tunis has woven a wondrously 
interesting history that merits the attention 
of today s generation of nurses. 

The close of World War I marked a 

JANUARY 1967 



books 



turning point in medical care. The change 
of emphasis from strictly curative to broad 
ly preventive programs brought with it a 
growing demand for nurses who were quali 
fied to go into the homes, the schools, and 
industries to teach the fundamentals of good 
health. Preparation for these new duties was 
not included in the curricula of many of 
the "training schools" of that day. It seemed 
logical, therefore, that the leaders in nurs 
ing should turn to the traditional sources 
of higher education the universities 
for guidance and assistance in developing 
the essential courses. Unhappily, organized 
nursing had not yet set its own educational 
standards either for admission to schools 
or for Ihe programs of instruction provided. 
Thus, it was inevitable that there should be 
difficulties in persuading universities of the 
validity of the requests for a place to be 
found within the university for nursing 
programs. 

That the original committee of nursing 
leaders in Montreal was able to achieve an 
initial goal by 1920 is a tribute to their 
dogged perseverence. With three different 
certificate courses established, student en 
rollment flourished. Financially, there were 
always problems to maintain the School, so 
the sharp depression of the thirties came as 
a shuddering, almost fatal blow. 

It was then that the active Alumnae As 
sociation, by a herculean effort, with Miss 
E. Frances Upton leading the way, raised 
the necessary funds. 

Throughout her history, Mrs. Tunis has 
given us many intimate biographical sketches 
of the people who have brought the School 
to its present stature. For these alone, In 
Caps and Gowns is worthy of interested 
reading. Through them she has portrayed 
not only their contributions to the School 
for Graduate Nurses but also an insight into 
the development of our own Canadian 
Nurses Association. 

We strongly recommend this history to 
instructors in our schools of nursing, to 
graduate nurses everywhere, and of course 
to those nurses who have been privileged 
to participate in any of the programs of 
study that are provided. 

Annotated Bibliography on Childhood 
Schizophrenia 1955-1964 by James R. 
Tilton, M.S., Marian K. DeMyer, M.D., 
and Lois Hendrickson Loew, M.S. 136 
pages. Toronto, Ryerson, 1966. 
Reviewed by Mrs. EM. Pollard, nursing 
administrator, Sherwood Hospital, Char- 
lottetown, P.E.I. 

The object of the authors has been to 
provide a comprehensive source of reference 
to the English-language writings on child- 
JANUARY 1967 



hood schizophrenia for the period 1955 to 
1964. 

The book is subdivided appropriately into 
seven sections: historical and general review 
articles; descriptions and diagnosis; etiology; 
biochemical, neurological, and physiological 
studies; family characteristics; treatment and 
care; and follow-up studies. In each section 
the annotations of the books and papers are 
concise and clear-cut. 

This bibliography should save many hours 
of searching through library shelves, as the 
books and periodicals listed are readily 
available in the libraries of psychiatric 
units. The objective of the authors has been 
accomplished. 



films 



Pharmacology 

Drugs and the Nervous System is a 

recently-released film showing the effects 
of drugs on organs and body systems. 
Aspirin is used to demonstrate how a drug 
works, but considerable emphasis is placed 
on the abuse or misuse of certain drugs, 
such as stimulants (amphetamines), depres 
sants (barbiturates, opiates), and halluci 
nogens (marijuana, LSD). 

The film is in color and runs for 16 
minutes. Full information can be obtained 
from Churchill Films, Educational Film 
Distributors Ltd., 191 Eglinton Ave. E., 
Toronto 12, Ontario. A rental fee is charged. 

Cardiac arrest 

The Nurse in Emergency Cardiopulmonary 
Resuscitation, a 16 mm., 15 minute, color, 
sound film, was released in fall 1966. It 
shows a hospital patient in acute cardio- 
pulmonary distress and emphasizes the 
nurse s function and responsibilities from 
the initiation of resuscitation through to 
transfer of the patient to the care of the 
physician. 

The film would be especially useful in 
inservice education programs, and for show 
ing in schools of nursing. It is available on 
loan from the Canadian Heart Foundation. 
1130 Bay Street, Toronto 5, Ont. 

Arthritis 

Rheumatoid Arthritis is a new, 30-minute, 
color, sound film designed primarily for the 
physician. However, it contains considerable 
information on aspects of this complex 
disease process that would be of considerable 
interest to student nurses and to graduate 
nurses working with patients suffering from 
these diseases. 

Etiology, diagnostic methods, and recent 
advances in treatment are demonstrated. 
Typical arthritic forms in the adult are 
shown and the development from monar- 
thritis to polyarthritis. 

The film may be borrowed from Film 
Library, Pfizer Company Ltd., 50 Place 
Cremazie, Montreal 11, Quebec. 



Next Month 



in 



The 

Canadian 
Nurse 



Estrogens 
and the 
menopause 



Care of 

patients 

with 

skin cancer 



Drug addiction 
research, 
treatment, and 
nursing care 



Photo credits 



Dominion-Wide, p. 8. 

Cerebral Palsy Assoc. of 
Quebec, p. 31. 

National Health and Welfare, 
pp. 44, 51. 

Miller Services, Toronto, p. 47. 



THE CANADIAN NURSE 55 



WORKSHOPS FOR 
DIRECTORS AND 
ASSISTANT DIRECTORS 



Six regional workshops for directors or assistant directors of nursing service in hospitals 
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through 
the P oblem-Solving Method. 

The workshops aim at stimulating directors and assistant directors of nursing service to use 
the problem-solving approach in the administration of nursing services. Key speakers will 
discuss techniques of problem-solving. Major problems in nursing services in Canada will be 
discussed. Through group work and case study methods skills in problem-solving will be 
developed. 

Two workshops will be held in the Spring: 
Region City 

Atlantic Halifax 

West Vancouver 



And four in the Fall: 

Reg; on 

Ontario 

Mid-West 

Ontario 

Quebec 



City 
Toronto 
Regina 
London 
Quebec City 



Date 

April 11-14, 1967 
May 2-5, 1967 

Dote 

October 17-20, 1967 
October 24-27, 1967 
November 7-10, 1967 
Nov. 28-Dec. 1, 1967 



Exact locations will be announced later. 

The workshop to be held in Quebec city will be conducted in the French language only. 
English language nurses in the province of Quebec are invited to attend one of the work 
shops held in Ontario. French language nurses in New Brunswick are invited to attend the 
workshop in Quebec city. 

The workshops are open to directors or assistant directors of nursing service in hospitals. 
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature 
of the workshop only full-time registrants can be accepted. 

Here is an opportunity for directors and assistant directors of nursing service: 

to sharpen skills in problem-solving within a 
"training laboratory" environment; 

to learn how problem-solving can be facilitated through group work; 

to stimulate orderly thinking toward the improvement of 
nursing service; 

to identify the leadership role of the director of nursing service 
and/or assistant director of nursing service in problem-solving and 
decision making. 

Interested! then plan now to attend the workshop in your area. Register early and avoid 
disappointment. 

I wish to register for the CNA Regional Workshop for Directors or 
Assistant Directors of Nursing Service in Hospitals held in : 



Halifax 

Vancouver 

Toronto 



Regina 
London 
Quebec City 



Years in Position 
Number of Beds 



Name 

Title of Position 

Name of Hospital 

City or Town 

Qualifications beyond RN 

I enclose postal note (bank money order) for $ 
payable to the Canadian Nurses Association. 

MAIL TO: 

CANADIAN NURSES 7 ASSOCIATION 

50 The Driveway 
Ottawa 4, Ontario 



accession list 



56 THE CANADIAN NURSE 



Publications in this list of material 
received recently in the CNA library are 
shown in language of source. The majority 
(reference material and theses, indicated by 
R excepted) may be borrowed by CNA 
members, and by libraries of hospitals and 
schools of nursing and other institutions. 
Requests for loans should be made on the 
"Request Form for Accession List" (page 
58) and should be addressed to: The Li 
brary, Canadian Nurses Association, 50 
The Driveway. Ottawa 4, Ontario. 

BOOKS AND DOCUMENTS 

1. Basic concepts in anatomy and phy 
siology by Catherine Parker Anthony. St. 
Louis, Mosby, 1966. 133 p. 

2. Bibliographical procedures and style by 
Blanche Pritchard McCrum and Helen Du- 
denbostel Jones. Washington, Library of 
Congress, 1954. 133 p. 

3. Canadian quotations and phrases, liter 
ary and historical by Robert M. Hamilton. 
Toronto, McClelland and Stewart, 1952. 
272 p. R 

4. Community colleges in Canada, Na 
tional seminar on The Community College 
in Canada, May 30, 31, June 1, 1966. To 
ronto, Canadian Association for Adult Edu 
cation, 1966. 109 p. 

5. Continuity of patient care: the role of 
nursing by K. Mary Straub and Kitty S. 
Parker. Washington, Catholic University of 
American Press. c!966. 232 p. 

6. The descriptive cataloging of library 
materials, 2d ed. rev., by Shirley L. Hop- 
kinson. San Jose, Calif., Claremont House, 
C1966. 78 p. 

7. Economic consequences of the profes 
sions by D.S. Lees. London, Institute of 
Economic affairs, 1966. 48 p. 

8. Education studies in progress in Can 
adian universities 1965 by the Canadian 
Education Association Research and Infor 
mation Division. Toronto, 1966. 210 p. R 

9. Essentials of chemistry by Gretchen O. 
Luros and Jack C. Towne. Philadelphia, 
Lippincott, c!966. 356 p. 

1 0. The foundations of nursing as con 
ceived, learned, and practiced in profes 
sional nursing by Lillian DeYoung. St. 
Louis, Mosby, 1966. 279 p. 

1 1 . Fundamentals of public health nursing 
by Kathleen M. Leahy and M. Marguerite 
Cobb. New York, McGraw-Hill, c!960. 225 p. 

12. Group psychotherapy in nursing prac 
tice by Shirley W. Armstrong and Sheila 
Rouslin. New York, MacMillan, c!963. 170 p. 

13. Issues in nursing by Bonnie Bullough 
and Vern Bullough. New York, Springer, 
c!966. 278 p. 

14. The leader and the process of change 
by Thomas R. Bennett, New York, Associa 
tion Press, c!962. 63 p. 

15. The life of Florence Nightingale by 
Sarah A. Tooley. New York. MacMillan, 

JANUARY 1967 



accession list 



London, Bousfield, 1905. 344 p. 

16. Maternity care in I he world: interna 
tional survey of midwifery practice and 
training. Report of a Joint Study Group 
of the International Federation of Gynae 
cology and Obstetrics and the International 
Confederation of Midwives. Oxford, Perga- 
mon Press, c!966. 527 p. 

17. No man stands alone by Amy V. Wil 
son. Sidney, B.C., Gray, 1966. c!965. 138 p. 

18. Nurse physician collaboration toward 
improved patient care. Papers from National 
Conference for Professional Nurses and Phy 
sicians, 2d, Denver, Col., Sept. 30-Oct. 2, 
1965, sponsored by The American Medical 
Association and The American Nurses As 
sociation. New York, American Nurses As 
sociation, c!966. 63 p. 

19. Nursing care plans. Study program in 
nursing management by the American Hos 
pital Association, Hospital Research and 
Education Trust. Chicago, American Hos 
pital Association, 1966. 77 p. 

V20. The nursing profession: five sociol 
ogical essays by Fred Davis. New York, 
Wiley, C1966. 203 p. 

21. The nursing service manual of policies 
and working relations 3d ed. prepared by 
St. Francis Hospital, Wichita, Kansas. St. 



Louis, Catholic Hospital Association, 1964. 
Iv. 

22. Opinions tie sept groupcs de pcrsonnes 
en contact avec I etudiantc infirmiere par 
rapport a des comportements generalement 
desirables ou inacceptables par Soeur Jeanne 
Forest. Montreal. 1966. Thesis Ottawa R 

23. Picture sources, 2d ed., by Celestine 
G. Frankenberg. New York, Special Libraries 
Association, c!964 216 p. R 

24. A plan for indexing the periodical 
literature of nursing by Vern M. Pings. New 
York, American Nurses Foundation, c!966. 
202 p. 

25. Processing manual; a pictorial work 
book of catalog cards by Althea Conley 
Herald. Teaneck, New Jersey, Fairleigh Dic 
kinson University Press, 1963. 88 p. 

26. Rehabilitation center planning an ar 
chitectural guide by Cuthbert A. Salmon and 
Christine F. Salmon. University Park. Penn., 
Pennsylvania State University Press, 1959. 
1964 p. 

27. Student nurse wastage by General 
Nursing Council for England and Wales. 
London. 1966. 48 p. 

28. A study of programs in selected 
schools of nursing to determine the liberal 
education content of the curriculum with 
specific reference to learning experiences 
related to nursing of the aged by Frances 
Edith Bell. London. 1966. 175 p. Thesis 
(M.Sc.N.) Western Ontario R 



29. A study of the relationship between 
the prediction of success in a school of 
nursing and clinical performance by Jeanne 
Dolores Zelech. Seattle, 1966. 87 p. Thesis 
(M.N.) Washington. R 

30. Taking the hospital to the patient; 
home care for the small community by John 
R. Griffith. Battle Creek, Mich., W.K. Kel 
logg Foundation, 1966. 55 p. 

31. Teaching and Administration in Nurs 
ing Associate Degree Programs, Second 
Seminar, Purdue University, July 18-30, 
1965. Report. Layfette, Indiana, Purdue 
University, Dept. of Nursing, 1965. 49 p. 

32. Textbook of anatomy and physiology 
for nurses by Diana Clifford Kimber and 
Carolyn E. Gray. 5th ed. rev. New York, 
MacMillan, 1919. 527 p. 

33. Today and tomorrow in western nurs 
ing by Western Interstate Commission for 
Higher Education. Bolder. Col., 1966. 108 p. 

PAMPHLETS 

34. Approved medical-nurse procedures 
by Registered Nurses Association of Nova 
Scotia. Halifax, 1966. 

35. A guide for staff education and staff 
development by the Registered Nurses Asso 
ciation of Ontario. Committee on Nursing 
Service. Toronto, 1966. 6 p. 

36. A guide to interviewing and counsel 
ing for the nurse in industry by the American 
Association of Industrial Nurses. Committee 



for anoredal 
comfort 
that laxtx! 

meet the patient s needs with 

ANUSOL 

Hemorrhoidal Suppositories and Ointment 

SAFE: Anusol contains no 
analgesics or narcotics and will 
not mask the symptoms of serious 
rectal pathology. 



WARN ER -CHI LCOTT 

Laboratories Co. Limited, Toronto, Canada 
Makers of Tedral.Brondecon, Choledyl 



JANUARY 1967 






CHASE 
HOSPITAL 
DOLLS 

For demonstrating and practicing the 
newest nursing techniques lavage and 
gavage tracheotomy and colostomy, 
and their post-operation care nasal 
and otic irrigations cafheterization and 
all abdominal irrigations subcutane 
ous, intramuscular and intradermal injec 
tions and all standard nursing procedures. 
Let us tell you about the new features we 
have added to this world-famous teaching 
aid. Write to 

M. J. CHASE Co. Inc. 156 Broadway 
Pawtucket Rhode Island 



THE CANADIAN NURSE 57 



accession list 



on Education. New York, American Asso 
ciation of Industrial Nurses. 1960. p. 21-28. 
(Reprint) R 

37. A guide to the responsibilities and 
qualifications for various positions in nurs 
ing .service by the Registered Nurses Asso 
ciation of Ontario. Committee on Nursing 
Education. Sub-Committee on Basic Degree 
Programs. Toronto, 1966. 2 p. 

38. A guide to the responsibilities and 
qualifications for various positions in nurs 
ing service by the Registered Nurses Asso 
ciation of Ontario. Committee on Nursing 
Service. Toronto, 1966. 8 p. 

39. How to use your library by Harold 
S. Sharp. New York. Consolidated Book 
Service. c!963. 17 p. 

40. Presentation on nursing needs for 
Prince Edward Island. Brief to the execu 
tive council of the Prince Edward Island 
Government by the Association of Nurses of 
Prince Edward Island. Charlottetown, 1966. 
10 p. 

41. A leaching guide to science and cancer 
by Ralph P. Frasier and others for the 
National Science Teachers Association. 
Washington, U.S. Dept. of Health, Educa 
tion and Welfare, Public Health Service, 
1966. 24 p. 



42. Teaching mental health in the basic 
nursing program by the Registered Nurses 
Assocication of Ontario. Committee on Nurs 
ing Education. Toronto, 1966. 10 p. 

GOVERNMENT DOCUMENTS 

Canada 

43. Internal migration in Canada, 1921- 
1961 by Isabel B. Anderson. Ottawa, Eco 
nomic Council of Canada, 1966. 90 p. 

44. Assurance medicale privee el paiement 
par anticipation par Charles H. Berry. Ot 
tawa, Imprimeur de la Reine, 1966. 255 p. 
(Commission royale d enquete sur les ser 
vices de sante.) 

45. The contribution of education to eco 
nomic growth by Gordon W. Bertram. 
Ottawa, Economic Council of Canada, 1966. 
150 p. 

Saskatchewan 

46. Dept. of Public Health. Ad hoc Com 
mittee on Nursing Education. Report. Re- 
gina, Queen s Printer, 1966. 226 p. 
United States 

47. Bibliographic aspects of medlars by 
Seymour I. Taine. Washington, U.S. Public 
Health Service; Reprint from Bull. Med. Lib. 
Assoc. v. 52, no. 1, Jan. 1964. p. 152-157. 

48. Dept. of Health, Education and Wel 
fare. Public Health Service. Focus resources 
in school health services. Washington, U.S. 
Govt. Print. Off., 1966. 20 p. 

49. Dept. of Health, Education and Wel 
fare. Public Health Service. Health man 



power source book, section 2, Nursing per 
sonnel. Washington, U.S. Govt. Print. Off., 
1966. 113 p. 

50. Dept. of Health, Education and Wel 
fare. Public Health Service. How to be a 
nurses aide in a nursing home; instructor s 
manual. Washington, U.S. Govt. Print. Off., 
1966. 20 p. 

51. Dept. of Health, Education and Wel 
fare. Public Health Service. Occupational 
mental health: an emerging art. Washington, 
U.S. Govt. Print. Off., 1966. p. 961-976. 

52. Dept. of Health, Education and Wel 
fare. Public Health Service. Public Health 
service film catalog 1966. Washington, U.S. 
Govt. Print Off., 1966. 99 p. 

53. Dept. of Health, Education and Wel 
fare. Public Health Service. Training pro 
grams of the National Institute of Mental 
Health. Washington, U.S. Govt. Print. Off., 
1966. 21 p. 

54. Design features affecting asepsis in 
the hospital by Richard P. Gaulin. Rev. 
Washington, U.S. Dept. of Health, Edcation 
and Welfare, Public Health Service, 1966. 
10 p. 

55. National Library of Medicine. Cum 
ulated index medicus, 1965. Washington. 
U.S. Govt. Print. Off., 1966. 4 pts. R 

56. Occupational health nurses: an initial 
survey by Mary Lou Bauer and Mary 
Louise Brown. Washington, U.S. Dept. of 
Health, Education and Welfare, Public 
Health Service, 1966. 146 p. 



Request Form for "Accession List" 
CANADIAN NURSES ASSOCIATION LIBRARY 

Send to: 

LIBRARIAN, Canadian Nurses Association, 50 The Driveway, Ottawa 4, Ontario. 

Please lend me the following publications, listed in the issue of The 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

Item Author Short title (for identification) 

No. 



Requests for loans will be filled in order of receipt. 

Reference and restricted material must be used in the CNA library. 

Borrower 



Position 

Address 

Date requested 



58 THE CANADIAN NURSE 



JANUARY 1967 



classified advertisements 



ALBERTA 



ALBERTA 



BRITISH COLUMBIA 




crements ro $4Hj, recognition gjven tor quoJiricaiions 
and experience. 28 days vacation plus 9 statutory 
holidays. Board and room available in modern 
nurses residence. Medical Insurance and Pension 
Plans available. Apply to: The Matron, or Adminis 
trator, Bow Island General Hospital, Bow Island, 
Alberta. 1-11-2 

Registered Nurses for new 50- bed active treatment 
hospital, situated only 15 miles from Edmonton. 
Salary $360 - $420 per month. Recognition given for 
previous experience. Excellent personnel policies and 
working conditions. For further information please 
write to; Miss M. Macintosh, R.N., Director of 
Nursing, Fort Saskatchewan General Hospital, Box 
1 270, Fort Saskatchewan, Alberta. 1 -39-2 




REGISTERED NURSES FOR GENERAL DUTY (WANTED) 

for a 37-bed General Hospital. Salary $380 - $440 
per month. Commencing with $375 with 1 year and 
$390 with 3 years practical experience elsewhere. 
Full maintenance available at $35 per month. Pen 
sion plan available, train fare from any point in 
Canada will be refunded after 1 year employment. 
Hospital located in o town of 1,100 population, 85 
miles from Capital City on a paved highway. 
Apply to: Two Hills Municipal Hospital, Two Hills, 
Alberta. 1-88-1 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$10.00 for 6 lines or less 
$2.00 for each additional line 

Rates for display 
advertisements on request 

Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 

The Canadian Nurses Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses Association of the 
Province in which they are interested 
in working. 



Address correspondence to: 

The 

Canadian 
Nurse 

50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 




NURSES FOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hat. 
Nurses on staff must be willing and able to take re 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses residence with all single rooms situated on 
hospital grounds. Apply to: Mrs. M. Hislop, Adminis 
trator and Director of Nursing, Bassano General Hos 
pital, Bossano, Alberta. 1-5-1 

General Duty Nurses (2) for active treatment hospital 
15 beds; 2 Doctors, minimum monthly salary $355 
commensurate with experience. Extra pay for even 
ings and nights. Fare refunded after 2 years satisfac 
tory service. Apply giving experience and references 
to: Matron Administrator, Box 98, Bonnyville, Alberta. 

1-10-3 B 

General Duty Nurses for an active accredited well 
equipped 64-bed hospital in a growing Town, popu 
lation 3,500. Centrally located between major cities. 
Full maintenance available in a new residence, $35.00 
per month. Alberta Registered Nurses salary $360.00 
- $420.00, commensurate with experience. Excellent 
personnel policies and working conditions. Apply: 
Director of Nursing, Brooks General Hospital, Brooks, 
Alberta. 1-13-1 A 

GENERAL DUTY NURSES salary range $4,140 to 
$4,980 per annum. 40 hour work week, modern liv- 
ing-in facilities available at moderate rates, if de 
sired. Civil Service holiday, sick leave cmd pension 
benefits. Apply to: Baker Memorial Sanatorium, De 
partment of Public Health, Calgary, Alberta. 1-14-3 

GENERAL DUTY NURSES for modern 25-bed hos 
pital on Highway No. 12, East-Central Alberta. 
Salary range $380 to $440. {including a regional 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronation Municipal Hospital, 
Coronation, Alberta. Tel.: 578-3803. 1-25-1B 

GENERAL DUTY NURSES for 64-bed, active treatment 
hospital, 35 miles South of Calgary. Salary range 
$360 - $420. Living accommodation available in 
separate residence if desired. Full maintenance in 
residence $35 per month. 30 days paid vacation after 
12 months employment. Please apply to: The Director 
of Nursing, High River Municipal Hospital, High 
River, Alberta. 1-46-1 




GENERAL DUTY NURSES for 94-bed General Hospftol 
located in Alberta s unique Dinosaur Badlands. $360 
- $420 per month, 40 hour week, 31 days vacation, 
pension, Blue Cross, M.S.I, and generous sick time. 
Apply to; Miss M. Hawkes, Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberta. 1-31-2 A 

General Duty Nurse for modern 50-bed active hos 
pital in Central Alberra, Highway No. 2. Basic salary 
$360 - $420, 40 hour week, pension plans and group 
Blue Cross. Full maintenance $35 available. Apply 
to: Administrator, Ponoka General Hospital, Box 699, 
Ponoka, Alberta. 1-72-3 

GENERAL DUTY NURSES (6) and CERTIFIED NURS 
ING AIDES for modern 72-bed hospital. Salary $355 
and $240 respectively; credit for experience; liberal 
policies. Accommodation available. Apply to: Ad 
ministrator, Providence Hospital, High Prairie, Al 
berta. 1-45-1 

Op 

act 
Salary 



Operating Room Nurse for new 30-bed hospital, 
ictive in surgery. Four doctors on medical staff. 
Salary commensurate with training and experience. 
Hospital located 20 miles west of Edmonton. Apply 
to: Director of Nursing, Stony Plain Municipal Hos 
pital, Stony Plain, Alberta. 1-99-1 



BRITISH COLUMBIA 



Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Registered Nurse* (or those eligible) to apply for 
positions in Medicine, Surgery and Psychiatry. Apply 
to : Director of Nursing. Victoria, British Columbia. 

2-76-4A 



Operating Room Head Nurse ($464 - $552), General 
Duty Nurses (B.C. Registered $405 -$481, non-Regis 
tered $390) for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, curling 
and bowl ing. Hot springs swimming nearby. Nurses 
residence, room $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36-1 

B.C. R.N. for General Duty in 32 bed General Hospi 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefits, modern, comfortable, nurses residence in 
attractive community close to Vancouver, B.C. For 
application form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. 1, Hope, B.C. 2-30-1 

GENERAL DUTY NURSES (Two) for active 66-bed 
hospital, with new hospital to open in 1968. 
Active in-service programme. Salary range $372 to 
$444 per month. Personnel policies according to 
current RNABC contract. Hospital situated in beauti 
ful East Kpotenays of British Columbia, with swim 
ming, golfing and skiing facilities readily available. 
Apply to: The Director of Nursing, St. Eugene Hos 
pital, Cranbrook, British Columbia. 2-15-1 

General Dufy Nurses for well-equipped 80-bed Gener 
al Hospital in beautiful inland Valley adjacent Lake 
Kathlyn and Hudson Bay Glacier. Initial salary $387. 
Maintenance $60, 40-hour 5 day week, vacation with 
pay, comfortable, attractive nurses residence, 
Boating, fishing, swimming, golfing, curling, skating, 
skiing. Apply to: Director of Nursing, Bulkley Valley 
District Hospital, P.O. Box No. 370, Smithers, British 
Columbia. 2-67-1 

General Duty Nurses (2 immediately) for active, 
26-bed hospital in the heart of the Rocky Mountains, 
90 miles from Banff and Lake Louise. Accommoda 
tion available in attractive nurses residence. Apply 
giving full details of training, experience, etc. to: 
Administrator, Windermere District Hospital, Inver- 
mere, British Columbia. 2-31-1 

General Duty Nurset for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in accordance with RNABC. Com 
fortable Nurses home. Apply: Director of Nursing, 
Boundary Hospital, Grand Forks, British Columbia. 

2-27-2 




General Duty O. R. and experienced Obstetrical 
Nurses for modern, 1 50-bed hospital located in the 
beautiful Fraser Valley. Personnel policies in ac 
cordance with RNABC. Apply to: Director of Nursing, 
Chilliwack General Hospital, Chilliwack, British Co 
lumbia 2- 13-1 

General Duty, Operating Room and Experienced 
Obstetrical Nurses for 434-bed hospital with school 
of nursing. Salary: $372-$444. Credit for past ex 
perience and postgraduate training. 40-hr, wk. Stat 
utory holidays. Annual increments; cumulative sick 
leave; pension plan; 28-days annual vacation; B.C. 
registration required. Apply: Director of Nursing, 
Royal Columbian Hospital, New Westminster, British 
Columbia. 2-73-13 



General Duty and Operating Room Nurses for 

modern 450-bed hospital with School of Nursing. 
RNABC policies in effect. 1966 salaries from $372 




JANUARY 1967 



Graduate Nurses for 31 -bed hospital on B.C. Coast. 
Salary $372 for B.C. Registered Nurses plus $15 
northern living allowance. Personnel policies in 
accordance with RNABC. Travel from Vancouver 
refunded after 6 mos. Apply: Administrator, General 
Hospital, Ocean Falls, British Columbia. 2-49-1 

GRADUATE NURSES for 24-bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel prac 
tices in accord with RNABC. Accommodation availa 
ble. Apply: Director of Nursing, General Hospital, 
Squamish, British Columbia. 2-68-1 

GRADUATE NURSES: Join us at the booming center 
of B.C. II Surrounded by 50 beautiful lakes with 
excellent boating, swimming, fishing plus oil winter 
sports. On hour s drive from Prince George, the 
fastest growing city in Canada. Active 44-bed hos 
pital and modern nurses residence over looking the 
picturesque Nechako River. Starting salary $372 - $408, 
recognition given for experience. Health and pension 
plan, 40-hr, week and 4 weeks vacation. Write to: 
Mrs. M. Grant, Director of Nursing, St. John Hospital, 
Vanderhoof, British Columbia. 2-74-1 

THE CANADIAN NURSE 59 



BRITISH COLUMBIA 



NOVA SCOTIA 



ONTARIO 



Graduate Nurses and Certified Nursing Assistants 

for 70-bed acute General Hospital on Pacific Coast. 
Salary for Graduates in accordance with RNABC 
scale with credit for experience; B.C. Registered 
Practical* $260-$296. Board and room $25/m; 4-wk. 
vacation after 1-yr. Superannuation and medical 
plans. Apply: Director of Nursing, St. George s 
Hospital, Alert Bay, British Columbia. 2-2-1 



MANITOBA 



Director of Nurses for up-to-date 38-bed hospital. 

New nurses residence of 1964 has separate nurses 
suite available. Sick leave, pension plan and other 
fringe benefits available. Personnel policies will be 
sent on request. Enquiries should include experience, 
qualifications and salary expected, and should be 
addressed to: Mr. O. Hamm, Administrator, Altona 
Hospital District No. 24, Box 660, Altona, Manitoba. 

3-1-1 



Registered Nurses (2) for 50-bed General Hospital in 
Fort Churchill, Manitoba. Starting salary $470 per 
month with higher 1967 schedule effective January 1. 
Train fare from Winnipeg refunded after six months 
service, and return fare refunded after one year 
service. Apply to: Director of Nursing. For 
Churchill General Hospital, Fort Churchill, Mani 
toba. 3-75-1 

Registered Nurses (1) for 21 -bed modern hospital. 
Duties to commence as soon as possible. Salary min. 
$405 - $490 with fringe benefits. Living-in accom 
modation available. A copy of our personnel policies 
will be mailed on request. Apply to: Mrs. C. James, 
Matron, Gilbert Plains District Hospital, Gilbert 
Plains, Manitoba. 3-25-2 

THE GLENBORO HOSPITAL has a position available 
for one Registered Nurse, effective as soon as pos 
sible. Glenboro Hospital is a 16-bed hospital lo 
cated 100 miles west of Winnipeg on No. 2 High 
way. Excellent residence accommodation available. 
Starting salary January 1st 1967 $395 per month. 
Personnel Policy Manual and application forms on 
request with no obligation. Please f or ward all en 
quiries to: Mr. S. A. Oleson, Box 130, Glenboro, 
Manitoba. Telephone No. 115 or No. 17 3-28-1 

Registered Nurse for 18-bed hospital at Vita Manitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
range $380 $440, with allowance for experience. 
40 hour week, 10 statutory holidays, 4 weeks paid 
vacation after one year. Full maintenance available 
for $50 per month. Apply; Matron, Vita District 
Hospital, Vita, Manitoba. 3-68-1 

Registered Nurses and Licensed Practical Nurses for 

232-bed Children s Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: Director of Nursing, Children s Hos 
pital, Winnipeg 3, Manitoba. 3-72-1 

Registered Nurse for General Duty in 20-bed hospital. 
Salary range $380 - $440 per month to be increased 
Jan. 1 , 1 967. Room and board available at $55.50 
per month. Generous personnel policies. Full details 
available on request. Apply: Director of Nursing, 
Reston Community Hospital, Reston, Man. 3-46-2 

Registered Nurses for General Duty for the newly 
built Swan River Hospital. Swan River is a progres 
sive town with excellent shopping and recreational 
facilities. Salary range $360 - $400 with excellent per 
sonnel policies. For full details contact: Mrs. E. R. 
Baud in, Director of Nursing, Swan River Hospital, 
Swan River, Manitoba. 3-62-2 

a 

p 

Trans Canada Highway. Apply: Director of Nursing 
Service, Portage District General Hospital, Portage La 
Prairie, Manitoba. 3-45-1 

Registered Nurses for Genera! Duty in 18-bed hospital. 
Daily bus service to larger centres. Starting salary 
$395 per month. All fringe benefits and residence 
available. Apply: Director of Nursing, Crystal City 
Memorial Hospital, Crystal Ci1y, Manitoba. 3-16-1 



eneral Duty Nurses for 100-bed active treatment hos- 
ital. Fully accredited. 50 miles from Winnipeg on 



NEW BRUNSWICK 



ADMINISTRATOR for Tobique Valley Hospital, Plaster 
Rock, New Brunswick. For further information apply: 
G. D. Gerrish, Secretary, Board of Management. 4-20-1 



NOVA 


SCOTIA 



Cape Breton Highland National Park. This position 
will be available January 1, 1967. Accommodations 
available. APPLY: giving qualifications to Secretary, 
Buchanan Memorial Hospital, Neil s Harbour, Nova 
Scotia. 6-25-1 

Registered Nurses for 21 -bed hospital in pleasant 
community Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital, 
Sheet Harbour, Nova Scotia, 6-32-1 



ONTARIO 



SUPERINTENDENT for 16-bed hospital, located 

60 THE CANADIAN NURSE 



Operating Room Supervisor for 70-bed fully accredited 
hospital. Competitive salary, good personnel policies. 
For complete information apply to: Director of Nursing, 
Alexandra Hospital, Ingersoll, Ontario. 7-60-1 

Co-ordinator of Clinical Nursing Studies in the 
Bachelor of Science in Nursing Course: The School 

of Nursing, McMaster University, invites applications 
from persons with advanced qualifications in clinical 
nursing. The position is open for the 1967-1968 
session, with duties commencing July 1967. Please 
apply sending curriculum vitae and two references 
ro : Director, School of Nursing, McMaster University, 
Hamilton, Ontario. 7-55-15 

Registered Nurses for 34-bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462. 3-wk. vacation with pay; sick leave after 
6-mo. service. All Staff 5 day 40-hr, wk., 9 
statutory holidays, pension plan and other benefits. 
Apply to: Superintendent, Eng ehart & District Hos 
pital, Englehart, Ontario. 7-40-1 

Registered Nurses. Applications and enquiries are 
invited for general duty positions on the staff of the 
Manitouwadge General Hospital. Excellent salary 
and fringe benefits. Liberal policies regarding ac 
commodation and vacation. Modern well-equipped 
33-bed hospital in new mining town, about 250-mi. 
east of Port Arthur and north-west of White River, 
Ontario Pop. 3,500. Nurses residence comprises indi 
vidual self-contained apts. Apply, stating qualifica 
tions, experience, age, marital status, phone number, 
etc. to the Administrator, General Hospital, Mani- 
touwadge, Ontario. Phone 826-3251 7-74-1 A 

Registered Nurses: Applications are invited for Gener 
al Duty Staff Nurses; Gross salary range: $362 to 
$422. Supervisory advancement opportunities. Resident 
accommodations available; Hospital situated in tourist 
town off Lake Huron. For further information write: 
Superintendent, Saugeen Memorial Hospital, South 
ampton, Ontario. 7-122-1 

Registered Nurses for 35-bed active treatment hospital, 
35 miles north east of Toronto, Ontario. Minimum 
salary $355 per month, and annual increments. Per 
sonnel policies including, Medical, O.H.S.C., weekly 
Indemnity Insurance, Ontario Hospital Pension Plan, 
and Group Life Insurance shared by the hospital, plus 
other benefits. Apply to: The Superintendent, The 
Cottage Hospital (Oxbridge), Uxbridge, Ontario. 

REGISTERED NURSES for 18-bed General Hospital in 
Mining and Resort Town of 5,000 people. Beautifully 
located on Wawa Lake, 140 mites north of Soult Ste. 
Marie, Ontario. Wide variety of Summer and Winter 
sports: swimming, boating, fishing, golfing, skating, 
curling and bowling. Six churches of different faiths. 
Salary range $375 - $450 per month. Starting salary 
up to $405; salary review at 3, 6, 12 months from 
date of hire, and annually thereafter. Differentia! 
pay for afternoon and night shifts. Bed and board 
available at reasonable rate. Excellent personnel 
policies. Pleasant working conditions. Apply to: The 
Administrator, The Lady Dunn General Hospital, 
Wawa, Ontario. 7-140-1 A 

Registered Nurses and Registered Nursing Assistants, 

for 100-bed General Hospital, situated in northern 
Ontario. Starting salary. Registered Nurses $390 per 
month. Registered Nursing Assistants $273 per month, 
shift differential, annual increment, 40 hour week, 
O. H. A. pension plan and group life insurance, 
O. H. S. C. and P. S. 1. plans in effect. Accommoda 
tion available in residence if desired. For full par 
ticulars apply: The Director of Nurses, Lady Min to 
Hospital, Cochrcne, Ontario. 7-30-1 A 

Registered Nurses and Registered Nursing Assistants 

are invited to make application to o jr 75-bed, 
modern General Hospital. You will be in the Vaco 
tionland of the North, midway between the Lakehead 
and Winnipeg, Manitoba. Basic salaries are $371 
and $259, with yearly increments. Write or phone: 
The Director of Nursing, Dryden District General 
Hospital, DRYDEN, Ontario. 7-26-1 A 

REGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS (IMMEDIATELY) for a new 40-bed hos 



pital with nurses residence. Nurses - minimum salary 
$387 plus experience allowance, 3 semi-annual incre 
ments of $10 each. R.N.A. s - $270 plus experience 
allowance, 2 annual increments of $10 each. Reply to: 
The Director of Nursing, Geraldton District Hospital, 
Geraldton, Ontario. 7-50-1 

Registered Nurses and Registered Nursing Assistants 

for 160-bed accredited hospital. Starting salary $387 
and $260 respectively with regular annual incre 
ments for botn. Excellent personnel policies. Resid 
ence accommodation available. Apply to: Director of 
Nursing, Kirkland & District Hospital, Kirkland Lake, 
Ontario. 7-67-1 

Registered Nurses and Registered Nursing Assistants: 

Applications are invited from R. N s and R. N. Ass ts. 
who are interested in returning to "nursing at the 
bedside" in a well-equipped General Hospital. Excel 
lent starting salaries and fringe benefits now. Further 
increase January 1, 1967. Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux Lookout General Hospital, P. O. Box 
909, Sioux Lookout, Ontario. 7-119-1 A 

Registered or Graduate Nurses, required for modern 
92-bed hospital. Residence accommodation $20 month 
ly. Overseas nurses welcome. Lovely old Scottish 
Town near Ottawa. Apply: Director of Nursing, The 
Great War Memorial Hospital, Perth, Ontario. 7-100-2 

Registered Nurses for General Duty in well-equipped 

28- bed hospital, located in growing gold mining 
and tourist area, north of Kenora, Ontario. Modern 
residence with individual rooms; room, board and 
uniform laundry only $45. 40-hr, wk., no split shift, 
cumulative sick time, 8 statutory holidays and 28 
day paid vacation after one year. Starting salary 
$400. Apply to: Matron, Margaret Cochenour Memo 
rial Hospital, Cochenour, Ontario. 7-29-1 

Registered Nurses for General Duty and Operating 
Room, in modern 100-bed hospital, situated 40 miles 
from Ottawa. Excellent personnel policies. Residence 
accommodation available. Apply to: Director of 
Nursing, Smiths Falls Public Hospital, Smiths Falls, 
Ontario. 7-120-2A 

Registered Nurses for General Duty in 100-bed hos 
pital, located 30-mi. from Ottawa, are urgently re 
quired. Good personnel policies, accommodation 
available in new staff residence. Apply: Director of 
Nursing, District Memorial Hospital, Winchester, On 
tario. 7-144-1 

Registered Nurses for General Duty and Operating 
Room in modern hospital (opened in 1 956). Situated 
in the Nickel Capital of the world, pop. 80,000 
people. Salary $372 per mo., with annual merit 
increments, plus annual bonus plan, 40-hr, wk. Recog 
nition for experience. Good personnel policies. Assist 
ance with transportation can be arranged. Apply: 
Director of Nursing, Memorial Hospital, Sudbury, 
Ontario. 7-127-4 



General Duty Nurses for 66-bed General Hospital. 
Starting salary: $375/m. Excellent personnel policies. 
Pension plan, life insurance, etc., residence accom 
modation. Only 10 min. from downtown Buffalo. 
Apply: Director of Nursing, Douglas Memorial Hos 
pital, Fort Erie, Ontario. 7-45-1 

General Duty Nurses for 100-bed modern hospital. 
Southwestern Ontario, 32 mi. from London. Salary 
commensurate with experience and ability; $398/m 
basic salary. Pension plan. Apply giving full par 
ticulars to: The Director of Nurses, District Memorial 
Hospital, Tilisonburg, Ontario. 7-131-1 

General Duty Nurses, Certified Nursing Assistants & 
Operating Room Technician (1) for new 50-bed hos 
pital with modern equipment, 40-hr, wk., 8 statutory 
holidays, excellent personnel policies & opportunity 
for advancement. Tourist town on Georgian Bay. 
Good bus connections to Toronto. Apply to: Director 
of Nurses, Genera! Hospital, Meaford, Ontario. 7-79-1 

General Staff Nurses and Registered Nursing Assis 
tants are required for a modern, well-equipped General 
Hospital currently expanding to 167 beds. Situated in 
a progressive community in South Western Ontario, 30 
miles from Windsor-Detroit Border. Salary scaled to 
experience and qualifications. Excellent employee 
benefits and working conditions plus an opportunity 
to work in a Patient Centered Nursing Service. Write 
for further information to: Miss Patricia McGee, B. 
Sc.N., Reg.N. Director of Nursing, Leamington District 
Memorial Hospital, Leamington, Ontario. 7-69-1 A 

PUBLIC HEALTH NURSE (QUALIFIED) For generalized 
Public Health programme. Present sa ary under revi 
sion. Direct enquiries to: Miss Beatrice Whalley, Super 
visor of Public Health Nursing, Waterloo Country 
Health Unit, 109 Argle Street, South. PRESTON, ON 
TARIO 10-109-2 

JANUARY 1967 



EL CAMINO HOSPITAL 

LOCATED IN BEAUTIFUL SANTA CLARA VALLEY 
YEAR ROUND SMOG-FREE TEMPERATE CLIMATE 



Registered Norses 
All Services 

Starting salary for 
Experienced 
Registered Nurses 
$550 per month 

448-bed fully-accred 
ited general hospi 
tal located 40 min 
utes south of 
downtown San 
Francisco 

Ample opportunity 
for professional 
development as 
there are two col 
leges and two uni 
versities in the 
immediate vicinity 

Excellent recreational 
facilities in close 
proximity to the 
hospital 






Benefits Include: 

Planned orientation 
program 

Continuing in-service 
education 

Two to four weeks 
vacation 

Eight paid holidays 

Accumulative sick 
leave 

Free group life 
insurance 

Fully paid health in 
surance including 
family coverage 

Fully paid retirement 
program 

Liberal shift 
differential 

40-hour week 



Apply to : 

PERSONNEL DIRECTOR 

El Camino Hospital 

2500 Grant Road 
Mountain View, California 94040 



DIRECTOR 
OF NURSES 

Applications are invited for this 
position in a 44-bed active Gen 
eral Hospital. Position carries a 
good deal of responsibility in 
cluding nursing personnel, phar 
macy, new projects planning. 
New projects are two new hos 
pitals with centralized services 
and exciting concepts for mod 
ern patient care. Located in Cen 
tral British Columbia, one hour 
west of Prince George in an area 
of noted development, this dis 
trict abounds with lakes and 
forests, good summer and winter 
sports. Excellent salary and staff 
benefits depending on qualifi 
cations and experience. 

Apply to: 
Administrator 

ST. JOHN HOSPITAL 

Vanderhoof, 
British Columbia 



ASSISTANT DIRECTOR 
OF NURSING 



Applications are invited for fhe position 
of Assistant Director of Nursing in an 
accredited, modern, 244-bed acute-care 
hospital. Located in the rapidly growing, 
scenic interior of British Columbia, this 
hospital is undergoing progressive ex 
pansion. 

Nursing administrative education and ex 
perience desirable. Salary commensurate 
with qualifications. 

Suite available in staff residence. 



Apply stating qualifications and 
expected salary to: 

Director of Nursing 

PRINCE GEORGE REGIONAL 
HOSPITAL 

Prince George, British Columbia 



OPERATING ROOM 
SUPERVISOR 

With Postgraduate Course in 

Operating Room technique 

and management 

Required for a 375-bed fully 
accredited General Hospital with 
projected reconstruction program. 
Salary based on qualifications 
and experience. 

Fringe benefits include hospital 
and medical coverage, generous 
sick leave, three weeks vacation 
and contributory pension plan. 

For further information write: 
Director of Nursing Service 

METROPOLITAN 
GENERAL HOSPITAL 

Windsor, Ontario 



JANUARY 1967 



THE CANADIAN NURSE 61 



ONTARIO 



SASKATCHEWAN 



UNITED STATES 



OPERATING ROOM NURSES (2) For a fully ac 
credited 70-bed General Hospital. For Operating 
Room Duty, Salary according to experience. Apply to: 
O.R. Supervisor, Penetanguishene General Hospital, 
Penefanguishene, Ontario. 7-99-2 

Public Health Nurses for generalized program. Every 
modern fringe benefit. Full credit for experience. 
Present salary range $5,030 $6,148. Further, we 
are prepared to give consideration to any salary 
request. Apply to: E. G. Brown, M.D., D.P.H. Director 
and M.O.H., Kent County Health Unit, 21 - 7th. St., 
Chatham, Ontario. 7-24-4 

PUBLIC HEALTH NURSES (2 QUALIFIED) Staff 
positions available in the City of Oshawa. Duties to 
commence January 3rd, 1967. Generalized program 
in on official agency. Salary $5,658 to $6,507. 
Beginning salary according to experience. Liberal 
personnel policies and fringe benefits. Apply to: Mr. 
D. Murray, Personnel Officer, City Hall, 50 Centre 
Street, Oshawa, Ontario. 7-92-2 

Public Health Nurses for generalized programme in 
a County-City Health Unit. Salary schedule as of 
January 1, 1967, $5,100 to $6,100. 20 days vacation. 
Employer shared pension plan, P.S.I, and hospital- 
ization. Mileage allowance or unit cars. Apply to : 
Miss Veronica O Leary, Supervisor of Public Health 
Nursing, Peterborough County-City Health Unit, P.O. 
Box 246, Peterborough, Ontario. 7-101-4A 

PUBLIC HEALTH NURSES for generalized public health 
program. Good personnel policies including 4 weeks 
vacation, sick time allowance, unit car or car allow 
ance, shored pension plan, hospitalization, and 
group insurance available. Apply to : Mrs. Muriel 
McAvoy, Secretary-Treasurer, Porcupine Health Unit, 
70 Balsam Street South, Timmins, Ontario. 7-132-2 



QUEBEC 



RESIDENT CHILDREN CAMPS IN THE LAURENTIANS, 
REQUIRE: Graduate Nurses for the summer. Apply: 
JEWISH COMMUNITY CAMPS, 6655 Cote des Neiges 
Road, Su ite 260, Montreal 26, Quebec. Phone 
735-3669. 9-47-63A 



SASKATCHEWAN 



DIRECTOR OF NURSING for modern 24-bed active 
treatment hospital. Graduates in nursing administration 
or with experience will be given preference. Accommo 
dation available in nurses residence. Salary schedule 
will be based on the SRNA recommandations. Apply: 
Mr. R. Holinaty, Administrator, Wakaw Union Hospital, 
Wakaw, Saskatchewan. 10-131-1 A 

MATRON for 10-bed hospital at Willow Bunch in 
South Central Saskatchewan. Population 600; bus 
service, modern utilities, recreational facilities, friend 
ly folks. $450 per month; 40 hour week. Room in 
nurses residence and board in hospital supplied at 
low cost. Call or write: R. Granger, Sec.-Treas., 
Willow Bunch Union Hospital, WILLOW BUNCH, 
Saskatchewan. PHONE: 473-2450 {Area Code 306). 

10-138-1 



Registered Nurses wanted for 12-bed hospital. Salaries 
and benefits as per SRNA schedule. Residence accom 
modation on hospital grounds. Daily bus service to 
cities. Apply to: The Matron, Mrs. M. Giles, Coronach 
Union Hospital, Coronach, Saskatchewan. 10-18-1 

REGISTERED NURSE for 9 bed hospital. Duties to 
commence as soon as possible. Salary according to 
SRNA schedule with allowance for experience. Room 
and board for $34.50 per month. Apply to: Secre 
tary, Hodgevrlle Union Hospital, HodgevMIe, Sas 
katchewan. 10-45-1 



REGISTERED NURSES for 24-bed active treatment hos 
pital. Established personnel policies and pension plan. 
Salary range as per SRNA recommendations. Adjust 
ments to starting salary made for previous experience. 
Residence accommodation available at $43.50 per 
month. Apply: Mrs. Z. Johnson, Acting Director of 
Nursing, Wakaw Union Hospital, Wakaw, Saskatche 
wan. 10-131-1 



Registered Nurse and Certified Nursing Assistant for 

45-bed General Hospital in progressive north central 
Saskatchewan community. Daily bus service to two 
major cities. SRNA policies and salaries in effect 
plus added fringe benefits, ie. group life insurance, 
pension plan, accumulative sick leave to 120 days. 
Board and single rooms available in residence at 
$43.50 per month. Apply to: Mrs. C. Fisher, R.N., 
Acting Director of Nursing, Wadena Union Hospital, 
Wadena, Sask. 10-130-1 

62 THE CANADIAN NURSE 



Registered Nurses for General Duty (2) in fully 
modern 27-bed hospital. Initial salary $364 per month. 
Personnel policies according to Sask. Reg. Nurses As 
sociation recommendations. New modern residence, 
excellent working conditions. Duties to commence 
when convenient. Apply to: Superintendent of Nursing 
Services. Kipling Memorial Union Hospital, Kipling, 
Saskatchewan. 10-59-1 




UNITED STATES 



Registered Nurses wanted for 78-bed General Hos 
pital, Starting salaries at $525 per month with 
regular increments and shift differential. Good per 
sonnel policies. Social activities include ski ing and 
boating. Must be eligible for Alaska registration. 
Apply to : The Director of Nursing Service, St. Ann s 
Hospital, 419 - 6th Street, Juneau, Alaska 99801. 

15-2-3 

REGISTERED NURSES Southern California Op 
portunities available 368-bed modern hospital in 
Medical-Surgical, Labor and Delivery, Nursey, Oper 
ating Room and Intensive and Coronary Care Units. 
Good salary and liberal fringe benefits. Continuing 
inservice education program. Located 10 miles from 
Los Angeles near skiing, swimming, cultural and edu 
cational facilities. Temporary living accommodations. 
Apply: Director of Nursing Service, Saint Joseph 
Hospital, Burbank, California 91503. 15-5-63 

REGISTERED NURSES needed for rapidly expanding 
general hospital on the beautiful Peninsula near 
San Francisco. Outstanding policies and benefits, 
including temporary accommodations at low cost, 
health coverage, fully refundable retirement plan, 
liberal shift differentials, no rotation, exceptional 
in-service and orientation programs, unlimited sick 
leave accrual, unlimited vacation accrual, sick leave 
conversion to vacation, tuition reimbursement. Ex 
cellent salaries based on experience. Contact Person 
nel Administrator, Peninsula Hospital, 1783 El 
Camina Real, Burlingame, California 697-4061 . 

1 5-5-20 B 

Registered Nurses, Career satisfaction, interest and 
professional growth unlimited in modern, JCAH ac 
credited 243-bed hospital. Located in one of Califor 
nia s finest areas, recreational, educational and cul 
tural advantages are yours as well as wonderful 
year-round climate. If this combination is what 
you re looking for, contact us nowlStaff nurse en 
trance salary above $500 per month; increases to 
$663 per month; supervisory positions at highest 
rates. Special area and shift differentials to $50 per 
month paid. Excellent benefits include free health 
and life insurance retirement, credit union and liberal 
personnel policies. Professional staff appointments 
available in all clinical areas to those eligible for 
California licensure. Write today: Director of Nursing, 
Eden Hospital, 20103 Lake Chabot Road, Castro Val 
ley, California. 15-5-12 

REGISTERED NURSES Opportunities available at 
415-bed hospital in Medical-Surgical, Labor and 
Delivery, Intensive Care, Operating Room and Psy 
chiatry. No rotation of shift, good salary, evening 
and night differentials, liberal fringe benefits. 
Temporary living accommodations available. Apply: 
Miss Dolores Merrell, R.N., Personnel Director, Queen 
of Angels Hospital, 2301 Bellevue Aevnue, Los 
Angeles 26, California. 15-5-3G 

REGISTERED NURSES Come to smog-free Orange 
in California. Near beaches and mountains; 35 miles 
from Los Angeles. New, modern 290-bed St. Joseph 
Hospital and adjoining 50-bed Childrens Hospital of 
Orange County. Need staff nurses oil shifts in 
surgical, medical, pediatrics, intensive care unit, 
cardiac care unit, neuropsychiatric unit, operating 
room, emergency room, and recovery room. Excellent 
salary and benefits. Write to: Personnel Director, 
St. Joseph Hospital, Orange, California, for personnel 
policy handbook and details regarding salaries, etc. 

15-5-56 

REGISTERED NURSES SAN FRANCISCO Children s 
Hospital and Adult Medical Center hospital for men. 
women and children. California registration required. 
Opportunities in all clinical areas. Excellent salaries, 
differentials for evenings and nights. Holidays, vaca 
tions, sick leave, life insurance, health insurance and 
employer-paid pension-plan. Applications and details 
furnished on request. Contact Personnel Director, Chil 
dren s Hospital, 3700 California Street, San Francisco 
18, California. 15-5-4 

REGISTERED NURSES General Duty for 84-bed 
JCAH hospital 1 J /2 hours from San Francisco, 2 
hours from Lake Tahoe. Starting salary $510/m. 



with differentials. Apply: Director of Nurses, Mem 
orial Hospital, Woodland, California. 15-5-49B 

Registered Nurses for 303 -bed modern hospital. Po 
sitions available All services, no shift rotation. 
Liberal benefits, advancement opportunities, educa 
tional opportunities in area, equal opportunity 
employer. Apply: Director of Nursing Service, Kaiser 
Foundation Hospitals, San Francisco 15, California. 
Phone {JO 7-4400) 15-5-57 

REGISTERED NURSES : Mount Zion Hospital and Me 
dical Center s increased salary scales now double our 
attraction for nurses who find they can afford to live 
by the Golden Gate. Expansion has created vacancies 
for staff and specialty assignments. Address enquiry 
to: Personnel Department, 1600 Divisadero Street, San 
Francisco, California 94115, An equal opportunity em 
ployer. 1 5-5-4 C 

Registered Nurses California. Expanding, accredit 
ed 303-bed hospital in medical center of Southern 
California. University city. Mountain ocean resort 
area. Ideal year-round climate, smog free. Starting 
salary $6,300. With experience, $6,600. Fringe bene 
fits, shift differential, initial housing allowance. 
Wide variety rentals available. For details on Cali 
fornia License and Visa, write: Director of Nursing, 
Cottage Hospital, 320 W. Pueblo Street, Santa Bar 
bara, California 93105. 15-5-39 A 

REGISTERED NURSES GENERAL DUTY SURGERY. 
Will assist with immigration. Come to California and 
live in beautiful Sacramento which is within a 
short drive of the Sierra summer and winter recrea 
tional areas. Two large modern hospitals offer an 
excellent variety of nursing experiences. P.M. Staff 
$555, P.M. Surgery $595. Write: Personnel Depart 
ment, Sutter Hospitals, 2820 "L" Street, Sacramento, 
California. 15-5-43B 

NURSE TEAM LEADER POSITIONS in new 372-bed, 
fully accredited, General Hospital in resort area. $461 
per month days and $485 per month evening and 
night shift. Liberal fringe benefits. For descriptive bro 
chure and policies write: L. Sims, North Miami Gene 
ral Hospital, 1701 NF. 127th Street, North Miami, 
Florida. 15-10-2 A 

REGISTERED NURSES: Excellent opportunity for ad 
vancement in atmosphere of medical excellence. Pro 
gressive patient care including Intensive Care and 
Cardiac Care Units. Finely equipped growing 200- 
bed suburban community hospital just on Chicago s 
beautiful North Shore. Completely air conditioned 
furnished apartments, paid vacation, after six months, 
staff development program, and liberal fringe bene 
fits. Starting salary from $466. Differential of $30 
for nights or evenings. Contact: Donald L. Thomp 
son, R. N., Director of Nursing, Highland Park Hos 
pital, Highland Park, Illinois 60035. 15-14-3 A 

Registered Nurses and Certified Nursing Assistants. 

Opening in several areas, all shifts. Every other week 
end off, in small community hospital 2 miles from 
Boston. Rooms available. Hospital paid life insurance 
and other liberal fringe benefits. RN salary $100 per 
week, plus differential of $20 for 3-11 p.m. and 
11-7 a.m. shifts. C.N. Ass ts. $76 weekly plus $10 for 
3-11 p.m. and 11-7 a.m. shifts. Write: Miss Byrne, 
Director of Nurses, Chelsea Memmorial Hospital, 
Chelsea, Massachusetts 02150. 15-22-1 C 

NURSES, Registered, for modern 360-bed hospital. 
Openings available in all areas, medicine-surgery, 
delivery room, nursery, and postpartum. Near Wayne 
State University, and an integral part of the new 
Medical Center. Salary $550 to $635 per month 
plus differential for afternoon and night. Premium 
pay for weekends. Good fringe benefits including 
Blue Cross and Life Insurance. Apply: Personnel 
Director, Hutzel Hospital formerly Woman s Hospital), 
432 East Hancock, Detroit, Michigan 48201. 15-23-1 F 

STAFF NURSES: Needed to staff present fully accredit 
ed hospital and new facility to open December 1967. 
All services and shifts available. Good salaries and 
fringe benefits. Will pay transportation to and from. 
Minimum one year contract. For particulars concerning 
hospital and community write: L. E. Thompson, Ad 
ministrator, or V. Jenkins, Director of Nursing, Scioto 
Memorial Hospital, Portsmouth, Ohio. 15-36-4 



ALBERTA 



General Duty Nurses and Certified Nursing Aides for 

modern combined active treatment ana Aux N iary 
Hospital. Salary starts at $355 and $240 respectively. 
Liberal personnel policies, accommodation available. 
Located in Southern Alberta close to U. S. boundary 
and Waterton-Glacier International Peace Park. The 
61 -bed combined hospital serves the town and area of 
approximately 6,000 population with all services. 
Apply to: The Director of Nursing, Cardston Municipal 
Hospital, Box 310, Cardston, Alberta. 1-17-1 

JANUARY 1967 



THE HOSPITAL 

FOR 

SICK CHILDREN 




\ 



YOU 



Receive the advantages of: 

1. Five-week orientation pro 
gram for new staff. 

2. Ongoing in-service education 
for nurses. 

3. Extensive student education 
program. 

4. Research Institute. 

APPLICATION FOR GENERAL 
DUTY POSITIONS INVITED 



For information contact: 

THE DIRECTOR OF NURSING 

555 University Avenue 
Toronto, Canada 



; 



UNITED STATES 



UNITED STATES 



REGISTERED NURSES FOR STAFF AND CHARGE. Posi 
tions in an expanding, fully accredited General 
Hospital. Intensive Care, Medical, Surgical, Obste 
trical areas, and In-service Education program. Lo 
cation: Central to beaches, mountains. State Uni 
versity. Good salary, regular increments. Opportunity 
for advancement. Apply: Director, Nursing Service, 
Beverly Hospital, 309 W. Beverly Blvd., Montebello, 
California. 15-5-59A 



Staff Duty positions (Nurses) in private 403-bed 
hospital. Liberal personnel pol icies and salary. Sub 
stantial differential for evenmg and night duty. 
Write: Personnel Director, Hospital of The Good 
Samaritan, 1212 Shatto Street, Los Angeles 17, 
California. 15-5-3B 



Nurses for new 75-bed General Hospital. Resort 
area. Ideal climate. On beautiful Pacific ocean. 
Apply to: Director of Nurses, South Coast Com 
munity Hospital, South Laguna, California. 15-5-50 



REGISTERED NURSES Positions available for Charge 
Nurses in beautifully equipped new convalescent hos 
pital, specializing in post surgical care. Work every 
other weekend. Contact the Personnel Director, Berkley 
Convalescent Hospital, Id23 Arizona Avenue, Sanfa 
Monica, California 90404. 15-5-40 B 

REGISTERED NURSES: for 75-bed air conditioned 
hospital, growing community. Starting salary $330- 
$365/m, fringe benefits, vacation, sick leave, holi 
days, life insurance, hospitalization. 1 meal furnish 
ed. Write: Administrator, Hendry General Hospital, 
Clewiston, Florida. 15-10-1 




. . . REGISTERED NURSES . . . 

THE 350-BED 

SARNIA GENERAL 



M CD 



F= I 



ASKS 

What Are You Seeking? 




WE OFFER 



the opportunity 

1. to work directly with patients 

2. to participate in group decisions 

3. L.O.A. with financial assistance to further your education 
in nursing 



If you are interested 



. . contact the Personnel Director, Sarnia General 
Hospital, Sarnia, Ontario 



JANUARY 1967 



THE CANADIAN NURSE 63 



OSHAWA 
GENERAL HOSPITAL 

GENERAL DUTY NURSES FOR 
ALL DEPARTMENTS 

Starting salary for Ontario Regis 
tered nurses $400 with 5 annual 
increments to $480 per month. 
Credit for acceptable previous 
service one increase for two 
years, two increases for four or 
more years. 

Non-registered $360.00 
Rotating periods of duty 3 
weeks vacation 8 statutory 
holidays. 

One day s sick credit per month 
beginning in the 7th month of 
service cumulative to 45 days. 
Pension Plan and Group Life 
Insurance Hospital pays 50% 
of Medical, Blue Cross and Hos 
pital Insurance premiums. 

Apply to: 
Director of Nursing 

OSHAWA GENERAL HOSPITAL 

Oshawa, Ontario 



ST. JOSEPH S 

HOSPITAL 

HAMILTON, 

ONTARIO 

A modern, progressive hospital, 
located in the centre of Ontario s 
Golden Horseshoe 
invites applications for 

GENERAL STAFF 
NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 

Immediate openings are avail 
able in Operating Room, Psy 
chiatry, Intensive Care Coro 
nary Monitor Unit, Obstetrics, 
Medical, Surgical and Paediatrics. 

For further information write to: 
THE DIRECTOR OF NURSING 

ST. JOSEPH S HOSPITAL 

Hamilton, Ontario 



REGISTERED NURSES 
for General Duty 

North Shore of Lake Athabaska 



Modern 30-bed General Hospital, 
located in young active mining 
community. 

Salary: $414 - $529. 
Attractive nurses residence a- 
vailable. Room and board at $45 
monthly. Superior employee ben 
efits. Air transportation paid 
from Edmonton or Prince Albert. 



Please send enquiries to the . 
Director of Nursing 

MUNICIPAL HOSPITAL 

Uranium City, 
Saskatchewan. 



DIRECTOR 
OF NURSING 



Applications are invited for the 
position of Director of Nursing. 
This is a unique hospital offering 
rehabilitation and chronic care to 
48 handicapped children who 
present many challenges. Ex 
pansion plans are being studied 
to provide rehabilitation for 18 
to 21 year old adolescents. Pre 
ference will be given to a director 
with preparation and experience 
in nursing administration and 
particular interest in rehabilita 
tion. 



Please address all enquiries to: 
The Administrator 

BLOORVIEW CHILDRENS HOSPITAL 

278 Bloor Street East 
Toronto 5, Ontario 



ASSISTANT DIRECTOR 
OF NURSING 

Applications are invited for the 
above position in a fully ac 
credited 163-bed General Hos 
pital in beautiful Northern On 
tario. 

Desirable qualifications should 
include B.S.N. Degree with ex 
perience in supervision. 

For further information, 
Write to : 

Director of Nursing 

KIRKLAND and DISTRICT HOSPITAL 

Kirkland Lake, Ontario. 




ONTARIO SOCIETY 

FOR 

CRIPPLED CHILDREN 

requires 

Camp Directors 

General Staff Nurses 

Registered Nursing Assistants 

for 
FIVE SUMMER CAMPS 

located near 

OTTAWA COLLING WOOD 

LONDON PORT COLBORNE 

KIRKLAND LAKE 

Applications are invited from nurses in 
terested in the rehabilitation of physically 
handicapped children. Preference given to 
CAMP DIRECTOR applicants having super 
visory experience and to NURSING ap 
plicants with paediatric experience. 

Apply in writing to: 

Miss HELEN WALLACE, Reg. N, 

Supervisor of Camps, 

350 Rumsey Road, 

Toronto 17, Ontario 



64 THE CANADIAN NURSE 



JANUARY 196; 




CANADA S INDIANS AND ESKIMOS 
NEED YOUR HELP 

PUBLIC HEALTH NURSES 

REGISTERED HOSPITAL NURSES 

CERTIFIED NURSING ASSISTANTS 

HAVE YOU CONSIDERED 

A CAREER 

WITH 

MEDICAL SERVICES 

DEPARTMENT OF NATIONAL HEALTH AND WELFARE 

for further information, write to : 

MEDICAL SERVICES DIRECTORATE 
DEPARTMENT OF NATIONAL HEALTH AND WELFARE 
OTTAWA, CANADA 



DIRECTOR OF NURSING 

Applications are invited 
for the 

POSITION OF DIRECTOR OF NURSING 

The Director of Nursing will be responsible for 
the administration of all nursing services within 
the hospital. The hospital currently operates 
375 beds and is undergoing extensive moderni 
zation and expansion costing $3,750,000. There 
is a furnished apartment available at a mini 
mum rental. A 140 student School of Nursing 
housed in a modern residence and operated 
by the hospital is the responsibility of a Director 
of Nursing Education. 

Address enquiries to: 
DOUGLAS M. McNABB, Administrator 

McKELLAR GENERAL HOSPITAL 

Fort William, Ontario 




THE SCARBOROUGH 
GENERAL HOSPITAL 

Invites applications from General Duty Nurses. 
Excellent personnel policies. An active and stimulat 
ing In-Service Education and Orientation Programme. 
A modern Management Training Programme to as 
sist the career-minded nurse to assume managerial 
positions. Salary is commensurate with experience 
and ability. We encourage you to take advantage 
of the opportunities offered in this new and expand 
ing hospital. 

For further information write to: 

Director of Nursing 

SCARBOROUGH GENERAL HOSPITAL 
Scarborough, Ontario 



JANUARY 1967 



THE CANADIAN NURSE 65 




YORK COUNTY HOSPITAL 

NEWMARKET, ONTARIO 
HOSPITAL: 

A newly expanded 257 bed hospital with such progressive 

patient care concepts as a 12-bed I.C.U., 22-bed psychiatric 

and 24-bed self care unit. 
IDEAL LOCATION: 

45 minutes from downtown Toronto, 15-30 minutes from 

excellent summer and winter resort areas. 
SALARIES: 

Registered Nurses: $372-$447 per month. 

Registered Nursing Assistants: $277-$310 per month. 
BENEFITS INCLUDE: 

Furnished apartments, medical and hospital insurance, group 

life insurance, pension plan, 40 hour week. 

Please address all enquiries to: 
Director of Nursing 

YORK COUNTY HOSPITAL 

596 Davis Drive 
Newmarket, Ontario 



TEACHERS OF NURSING 

By August, 1967 the Royal Victoria Regional School 
of Nursing requires three teachers in medical-surgical 
nursing, two in Operating Room techniques and one 
in psychiatric nursing. 

Teachers qualified with a baccalaureate degree or a 
diploma in nursing education will assist in classroom 
teaching and accompany the students to one of the 
six regional hospitals for clinical experience. 

This is a new programme in an independent school. 
The faculty are eager to develop the best possible 
curriculum. A new building for classrooms will be 
erected in 1967. 

Barrie is fifty miles north of Toronto and noted for its 
summer and winter sport facilities. 

Salaries are at the Toronto level with increments paid 
to experienced teachers. Personnel policies and job 
descriptions will be sent on request. 

Please write to: 
The Director, 

ROYAL VICTORIA REGIONAL SCHOOL OF NURSING 

61 Wellington Street West, Barrie, Ontario. 



MAIMONIDES HOSPITAL 
AND HOME FOR THE AGED 

AN OPPORTUNITY.... 
A CHALLENGE .... 

A NEW EXPERIENCE.... 

SUPERVISORS, STAFF NURSES, NURSING 
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC 
NURSE: 

We invite you to join the nursing staff of New Mai- 
monides. 

LIBERAL VACATION .... HEALTH AND 
PENSION PLANS .... SALARIES COM 
MENSURATE WITH RECOGNIZED SCALES 

Apply to: 

DIRECTOR OF NURSING 

5795 Caldwell Avenue 
Montreal 29, Quebec 



THE ST. CATHARINES 
GENERAL HOSPITAL 

A modern 500-bed hospital located in the heart 
of the beautiful Niagara Peninsula, within 
easy travel distance from Buffalo, Hamilton 
and Toronto, invites applications from: Gener 
al Staff Nurses. 

Pleasant working conditions. Excellent per 
sonnel policies. 



Apply: 
The Director of Nursing Service 

THE ST. CATHARINES 
GENERAL HOSPITAL 

St. Catharines, Ontario 



66 THE CANADIAN NURSE 



JANUARY 1967 



What does 
Methodist Hospital 
have to offer me? 



At the Methodist Hospital, where research is a part 
of progress, a nursing career takes on new horizons 
rich in meaning and professional satisfaction. 

If you re looking for the chance to be the nurse 
you ve always dreamed of coming to the world 
famous Methodist Hospital can be an adventure 
almost like stepping into the future splendid 
facilities, so much advance equipment and 
everywhere the newest medical and patient care 
techniques are in use. 

Some of the best aspects of nursing at METHODIST 
are as old as medicine itself there is a spirit of 
kindness and consideration, and emphasis on patient 
care, that make this a hospital where nursing is 
satisfying and rewarding, day by day. 

Methodist Hospital is right in the center of the world s 
great Medical, Research and Educational complexes. 
HOUSTON is an exciting city rodeo and opera, 
pro-football and the famous Alley Theatre, water sports 
and beaches an hour or less away, the Houston 
Symphony and the Astrodome! 



A Few Quick Facts: We re affiliated with Baylor 
University College of Medicine and associated with 
Texas Woman s University College of Nursing. 
New $9Vi million Cardiovascular and Orthopedic 
Research Center will open soon. Our Inservice 
Education Department gives you thorough 
orientation, and continued instruction in new 
concepts and techniques. You ll find every 
encouragement to broaden your skills, 
including tuition assistance in obtaining 
further education in nursing. 



Send for Your Colorful Informative Illustrated 
Brochure ... to learn about Methodist Hospital, 
Houston, positions available, salary and employment 
benefits, tuition allowance, complimentary room 
accommodation and our Nurse Specialist Programs. 
Write, call or send coupon. Director of Personnel, 
The Methodist Hospital, Texas Medical Center, 
Houston, Texas 77025 



Director of Personnel, THE METHODIST HOSPITAL , Texas Medical Center, Houston, Texas 77025 

Please send me your brochure about nursing opportunities at THE METHODIST HOSPITAL Texas Medical Center 



Name- 



Address- 
City 



. State . 



-Zip Code. 




DIRECTOR OF SCHOOL 
OF NURSING 

REQUIRED FOR 
DISTRICT SCHOOL OF NURSING 

Minimum Requirement B. Sc. N., with five years 
experience, two of these in Nursing Education. 

Apply to : 

Mr. Harold Swanson, Chairman, 
BOARD OF NURSING EDUCATION 

220 Clarke Street 
WOODSTOCK, ONTARIO 



The 

Canadian 
Nurse 



1965 INDEX 

An index of materials appearing 
in Volume 61 of 

THE CANADIAN NURSE 

is now available. 

Write for your copy to 

Miss PIERRETTE HOTTE 

at National Office, 

50 The Driveway, 

Ottawa 4 



JANUARY 1967 



THE CANADIAN NURSE 67 



ADDITIONAL CLINICAL TEACHERS 

required 

to assist in Developing New Curriculum and a 

Regional School. 
School of Nursing Building is New 

and well equiped. 

Salaries and Fringe Benefits at Metropolitan Level. 
Qualifications B.Sc.N. 

or 
Diploma in Nursing Education. 



GENERAL STAFF NURSES 

Required for all Services 
Salaries and Fringe Benefits at Metropolitan Level. 



Apply to : 
DIRECTOR OF NURSING 

BRANTFORD GENERAL HOSPITAL 

Brantford, Ontario 



MANITOBA ASSOCIATION 
OF REGISTERED NURSES 

Invites applications for the positions of 
REGISTRAR 

Applicants are required to hold a baccalaureate degree in nursing 
with experience in administration, and in interpersonal relations. 
Duties include providing for registration and membership in the 
M.A.R.N. and the maintenance of the official register of member 
of the Association. 
Salary to be Negotiated. 

and 
PERSONNEL OFFICER 

The applicant must have the following qualifications: 

Baccalaureate Degree desirable. Master s Degree preferred. 

Experience in administration and in working with individuals and 

organizations desired. 

Duties include promotion of the economic and social welfare of 

nurses. 

Salary to be Negotiated. 

All Inquiries should be Addressed to: 
Mrs. Helen P. Glass, President, 

MANITOBA ASSOCIATION OF REGISTERED NURSES, 

247 Balmoral Street, 
Winnipeg 1, Manitoba. 




UNIVERSITY 

OF ALBERTA 

HOSPITAL 

Positions are available in our 
rapidly expanding Medical Cen 
tre situated on a growing Uni 
versity campus. All service in 
cluding renal dialysis, coronary 
intensive care and cardiac surg 
ery offer opportunities for ad 
vancement. 

Apply to: 
Director of Nursing 

UNIVERSITY OF ALBERTA 
HOSPITAL 

Edmonton, Alberta 



STAFF NURSE POSITIONS 
Salary Range $482-3620 

with maximum starting $539 on day shift, 
$592 evening and/or night shifts. Credit 
given for education and/or experience. 
Opportunity to gain knowledge and skill 
in a specialized cancer research hospital. 
Registration in Texas required. Excellent 
personnel benefits include: 3 weeks vaca 
tion, holidays, cumulative sick leave, 
laundry of uniforms furnished, retirement 
and Social Security programs, Hospitaliza- 
tion, Life and Disability Income Insurance 
available. Equal opportunity employer. 

For application and additional information 
Write to : 

Personnel Manager 

THE UNIVERSITY OF TEXAS 

M.D. ANDERSON HOSPITAL AND 

TUMOR INSTITUTE 

Texas Medical Center 
Houston, Texas 77025 



RIVERSIDE 

HOSPITAL 

OF OTTAWA 

A new, air-conditioned 340-bed 
hospital. Applications are called 
for Nurses for the positions of: 

HEAD NURSE Operating Room 
ASSISTANT HEAD NURSES 
GENERAL STAFF NURSES 

and 

REGISTERED NURSING ASSISTANTS 

Address all enquiries to: 
Director of Nursing 

RIVERSIDE HOSPITAL OF OTTAWA 

1967 Riverside Drive, 
Ottawa, Ontario 



68 THE CANADIAN NURSE 



JANUARY 1967 



PALO ALTO-STANFORD 
HOSPITAL CENTER 

Located on the beautiful campus of Stanford University in Palo Alto, California. 




"We invite you to join our professional staff and to gain unparalled experiences in 
nursing." 

For additional information 

NAME: 

ADDRESS: 

CITY: STATE: 

SERVICE DESIRED: 

Return to.- pALO ALTO-STANFORD HOSPITAL CENTER 

Personnel Department 

300 Pasteur Drive 
Palo Alto, California 



REGISTERED NURSES 

REGISTERED NURSING 
ASSISTANTS 

REQUIRED FOR 

ST. MARY S HOSPITAL 

TIMMINS, ONTARIO 

MODERN 200 BED HOSPITAL 

EXCELLENT PERSONNEL POLICIES 

PLEASANT TOWN OF 30,000 

WIDE VARIETY OF SUMMER 

AND WINTER SPORTS 

SWIMMING, BOATING, 

FISHING, GOLFING, SKATING, 

CURLING, TOBOGGANING, 

SKIING AND ICE FISHING. 

Apply to: 
Director of Nursing Service 

ST. MARY S HOSPITAL 

Timmins, Ontario 



VICTORIA HOSPITAL 

LONDON, ONTARIO 

Modern l,000-bed hospital 
Requires 

Registered Nurses for 
all services 

and 

Registered 
Nursing Assistants 

40 hour week Pension plan 
Good salaries and Personnel 
Policies. 

Apply: 
Director of Nursing 

VICTORIA HOSPITAL 

London, Ont. 



ST. JOSEPH S HOSPITAL 

TORONTO, ONTARIO 

REGISTERED NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 

700-bed fully accredited hospital provides 
experience in Operating Room, Recovery 
Room, Intensive Care Unit, Pediatrics 
Orthopedics, Obstetrics, General Surgery 
and Medicine. 

Orientation and Active Inservice program 
for all staff. 

Salary is commensurate with preparation 
and experience. 

Benefits include Canada Pension Plan, 
Hospital Pension Plan, Group Life Insu 
rance. Sick leave 12 days after one 
year, Ontario Hospital Insurance 50% 
payment by hospital. 

Rotating Periods of duty 40 hour week, 
8 statutory holidays annual vacation 
3 weeks after one year. 

Apply: 

Assistant Director of 
Nursing Service 

ST. JOSEPH S HOSPITAL 

30 The Queensway 
Toronto 3, Ontario 



IANUARY 1967 



THE CANADIAN NURSE 69 



THE HOSPITAL 



FOR 



SICK CHILDREN 




OFFERS: 



1. Satisfying experience. 

2. Stimulating and friendly en 
vironment. 

3. Orientation and In-Service 
Education Program. 

4. Sound Personnel Policies 

5. Liberal vacation. 

APPLICATIONS FOR REGISTERED 
NURSING ASSISTANTS INVITED. 

For detailed information 
please write to: 

The Assistant Director 

of Nursing 
AUXILIARY STAFF 

555 University Avenue 
Toronto, Ontario, Canada 



NUMBER MEMORIAL HOSPITAL 

HOSPITAL 

Newly expanded 350-bed hospital. Progressive patient care con 
cept. 

SALARY 

General Staff Nurses (Currently Registered in Ontario) $400.00 - 
$480. 5-increments. 

Registered Nursing Assistants (Currently Registered in Ontario) 
$295.00 - $331.00, 3 increments. 

HOUSING 

Furnished apartments available at subsidized rates. 

JOB SATISFACTION 

High quality patient care and friendly working environment. We 
appreciate our personnel and encourage their professional develop 
ment. 

You are invited to enquire concerning employment opportunities to: 
Director of Nursing 

NUMBER MEMORIAL HOSPITAL 

200 Church Street, Weston, Ontario 
Telephone 249-8111 (Toronto) 



CALGARY GENERAL HOSPITAL 

requires immediately 

REGISTERED GENERAL DUTY NURSES 



This is a modern 1,000-bed hospital including a new 
200-bed convalescent-rehabilitation section. Benefits 
include Pension Plan, sick leave, and shift differen 
tial plus a liberal vacation policy and salary range 
$360 - $420 per month commensurate with training 
and experience. 

Apply to: 

Director of Nursing Service 

CALGARY GENERAL HOSPITAL 

Calgary, Alberta 



70 THE CANADIAN NURSE 



JANUARY 1967 




specialization 




education 





recreation 



Specialize at either the 424 bed Grace Central 
Hospital in the new $250 million Detroit Medical 
Center or at the 448 bed Grace Northwest Hospital. 
(Grace is second largest in terms of admissions in 
Michigan.) 

Further your education at nearby Wayne State 
University or one of the many smaller colleges 
nearby. 

Enjoy your leisure time in the heart of the 
cultural and entertainment center of dynamic 
Detroit or enjoy the all-year around sports and 
recreation of Michigan. 

Staff nurses at Grace earn from $500 to $600 
per month for days and $514 to $629 for evening 
and night duty plus very generous fringe benefits. 
Other positions pay even more. For full informa 
tion contact: Director of Nursing. 



GRACE CENTRAL HOSPITAL 

4160 John R. Street. 
Detroit. Michigan 48201 

or 
GRACE NORTHWEST HOSPITAL 

18700 Meyers Road. 
Detroit. Michigan 48235 



IANUARY 1967 



ASSISTANT 

ADMINISTRATOR 

(NURSING) 



To assume full responsibility 
for the nursing service functions 
of a 1,000 bed teaching hospital, 
located in a modern medical 
centre, and to coordinate nursing 
education activities with the ser 
vice functions. 

Post Graduate qualifications in 
nursing, hospital management, 
or business administration; and 
administrative experience rela 
ted to the responsibilities of this 
position, are required. 

The salary level will recognize 
the responsibilities of the position 
and the qualifications of the ap 
plicant. 



Director of Nursing 
Service 

Required to assist in the ad 
ministration of the Department 
of Nursing in directing and 
supervising patient care. 

Post Graduate Nursing quali 
fications and experience in 
nursing administration or super 
vision, are desired. 

Attractive salary and benefits. 



Please direct applications to: 

Dr. L. O. BRADLEY, 
Executive Director, 

WINNIPEG GENERAL 
HOSPITAL 

700 William Avenue, 
Winnipeg, Manitoba 

Phone Area #204 774-6511 
Collect 




If you re ready for a change, but 
reluctant to make the move, we 
have an added incentive a free 
airline ticket. Of course, it isn t 
really free you ll have to take a 
position in a modern, progressive, 
expanding hospital and you ll 
have to live in a mild, sunny met 
ropolitan area, rich in educational 
and cultural opportunities. But 
that isn t too much to ask, is it? 




PRESBYTERIAN HOSPITAL CENTER 
ALBUQUERQUE, NEW MEXICO 87106 

"Starting salary to $555 a month 
" 500-bed hospital 
Personal orientation program 
" Liberal fringe benefits 
" Continuing educational programs 
- Career advancement opportunities 
* ! Two universities 
-"Twenty minutes from nearby 
mountain ski area 

EQUAL OPPORTUNITY EMPLOYER 
Mail coupon or call collect (505-243-941 1, Ext. 219) 



Mrs. Susan Dicke, Director of Nurse Recruitment 
Presbyterian Hospital Center, Department B 
Albuquerque. New Mexico 87106 

Please mail me more information about nursing 
at Presbyterian Hospital Center and tell me how 
I may fly there at your expense. 



Name 



Address- 
City 



State. 



School of Nursing_ 
Year of Graduation. 



_Month_ 



THE CANADIAN NURSE 71 



SCHOOL OF NURSING 
WOODSTOCK GENERAL HOSPITAL 

Requires the following Faculty 

a) Psychiatric Teacher (One). 

b) Medical and Surgical Teachers (Two). 
Minimum requirement B. Sc. N. 

The above additional staff is required 
for New Program. 

Apply to: 

Director of Nursing Education 
WOODSTOCK GENERAL 

HOSPITAL 
Woodstock, Ontario 



OPERATING ROOM 
SUPERVISOR 

Postgraduate trained. 

For 61 -bed well-equipped 

hospital. 

Apply: 

Administrator 

WILLETT HOSPITAL 

Paris, Ontario 



SCHOOL OF NURSING 

PUBLIC GENERAL HOSPITAL 

Chatham, Ontario 
requires 

INSTRUCTORS 

Student Body of 130 

Modern self-contained education buildinc 

University Preparation required with 

salary differential for Degree. 

for further information, 
apply to: 

Director, Nursing Education 



SOUTH PEEL HOSPITAL 

COOKSVIUE, ONTARIO 

A new 450-bed General Hospital, located 
12 miles from the City of Toronto, has 
openings for: 

(1) GENERAL STAFF NURSES in all de 
partments; 

(2) Registered Nursing Assistants in all 
departments. 



for information or application, write to: 

Director of Nursing 

SOUTH PEEL HOSPITAL 

Cooksville, Ontario 



PUBLIC HEALTH NURSES 

required for 
HEALTH BRANCH 
B. C. Civil Service 

Positions available for qualified Public 
Health Nurses in various centres in British 
Columbia. 

SALARY: $432 - $530 per month; car 
provided. An opportunity for interesting 
and challenging professional service in this 
beautiful and fast-developing Province. 

For further information and application 

forms, apply to: 

The Director, Public Health Nursing, 

Department of Health Services and 

Hospital Insurance, Parliament Buildings, 

VICTORIA, B. C., or to The Chairman, 

B.C. CIVIL SERVICE COMMISSION, 

544 Michigan Street, 

VICTORIA, B.C. 
COMPETITION No. 66:281 A 



GRADUATE NURSES 

Eligible for registration in the 
Province of Ontario. 

Various positions available as SUPER 
VISORS, HEAD NURSES, and GENERAL 
DUTY NURSES. Excellent opportunities for 
advancement in all areas of modern, 
newly expanded 1,000-bed General Hos 
pital, including O.R. and Recovery, Inten 
sive Care, Emergency, Central Supply, 
Medical and Surgical Units. 

Please contact: 

Director of Nursing 

HENDERSON GENERAL 

HOSPITAL 
Hamilton, Ontario 



KINGSTON GENERAL HOSPITAL 

KINGSTON, ONTARIO 

Interesting changes in our physical plant 
are taking place at Kingston General 
Hospital. We invite you to join our 
Nursing Staff and share in providing 
quality care to our patients. We offer 
you a basic orientation and an ongoing 
education programme. Starting salary is 
dependent on Ontario registration, pre 
paration and experience. Kingston is the 
home of Queen s University and the 
Royal Military College and is ideally 
located in the Thousand Islands area, 
as well as close to the Metropolitan 
areas of Montreal, Toronto and New 
York City. 

Apply to: 

MISS S. M. BURKINSHAW, 
Director of Nursing. 



PETERBOROUGH CIVIC HOSPITAL 

School of Nursing requires 
INSTRUCTRESS (Nursing Arts) 
INSTRUCTRESS (Medical-Surgical Area) 

New self-contained education building for 
school of nursing now open. 

Trent University is situated in Peterborough 

For further information write to: 

Director of Nursing 
PETERBOROUGH CIVIC 

HOSPITAL 
Peterborough, Ontario 



REGISTERED GENERAL 
DUTY NURSES 

For 75-bed active hospital located 70 
miles East of Saskatoon. 

Excellent personnel policies. 

Apply : 

Director of Nursing Service 

ST. ELIZABETH S HOSPITAL 

Humboldt, Saskatchewan 



72 THE CANADIAN NURSE 



JANUARY 1967 



nurses 

who want to 

nurse 



At York Central you can join 
an active, interested group of 
nurses who want the chance to 
nurse in its broadest sense. Our 
126-bed, fully accredited hospi 
tal is young, and already talking 
expansion. Nursing is a profes 
sion we respect and we were the 
first to plan and develop a unique 
nursing audit system; new mem 
bers of our nursing staff do not 
necessarily start at the base salary 
of $372 per month but get added 
pay for previous years of work. 
There are opportunities for gain 
ing wide experience, for getting 
to know patients as well as staff. 

Situated in Richmond Hill, all 
the cultural and entertainment fa 
cilities of Metropolitan Toronto 
are available a few miles to the 
South . . . and the winter and 
summer holiday and week-end 
pleasures of Ontario are easily 
accessible to the North. If you 
are really interested in nursing, 
you are needed and will be made 
welcome. 



Apply in person or by mail to the 
Director of Nursing. 

YORK 
CENTRAL 
HOSPITAL 

RICHMOND HILL, 

ONTARIO 

NEW STAFF RESIDENCE 



Registered Nurses 

AND 

Registered 
Nursing Assistants 

For 300-bed Accredited General 
Hospital situated in the pictur 
esque Grand River Valley. 60 
miles from Toronto. 

Modern well-equipped hospital 
providing quality nursing care. 
Excellent personnel policies. 

For further information write: 
Director of Nursing Service 

SOUTH WATERLOO 
MEMORIAL HOSPITAL 

Gait, Ontario 



REGISTERED NURSES 

250-bed General Hospital, ex 
panding to 400, located in San 
Francisco, California. Positions on 
all shifts for nurses in Intensive 
Care Unit, Operating Room, and 
General Staff Duty. Salary range 
effective April 1967, $600-$700. 
Health and Life Insurance, Retire 
ment Program all hospital 
paid. Liberal holiday and vaca 
tion benefits. Accredited medical 
residencies in Medicine, General 
Surgery, Neuro Surgery, Ortho 
pedics, and Plastic Surgery. 

For further information write to: 

Miss Lois Jann, 
Director of Nursing 

FRANKLIN HOSPITAL 

14th and Noe Streets, 
San Francisco, California 



THE 

NORTHWESTERN 
GENERAL 
HOSPITAL 




THE HOSPITAL 

Fully accredited 
Progressive 250 bed hospital 
Planned expansion to 400 beds 
20 minutes to downtown Toronto. 



YOUR PROFESSIONAL GROWTH 

Planned orientation programme 
Continuing inservice education. 



BENEFITS INCLUDE 

3 weeks vacation 
8 statutory holidays 
Cumulative sick leave 
Group life insurance 

Hospitalization 
40 hour week. 

HOUSING 

Furnished apartments at reduced rates. 

For information contact: 
Director of Nursing 

NORTHWESTERN 
GENERAL HOSPITAL 

2175 Keele St., 
Toronto 15, Ont. 



JANUARY 1967 



THE CANADIAN NURSE 73 



WOODSTOCK GENERAL HOSPITAL 

Requires 
GENERAL STAFF NURSES 

ALL DEPARTMENTS 

and 

O.R. TECHNICIANS 

Apply: 

Director of Nursing 

WOODSTOCK 
GENERAL HOSPITAL 
Woodstock, Ontario 



PORT COLBORNE 
GENERAL HOSPITAL 

PORT COLBORNE, ONTARIO 

STAFF NURSES 

required 

For 1 66-bed hospital within easy driving 
distance of American and Canadian me 
tropolitan centres. Consideration given for 
previous experience obtained in Canada. 
Completely furnished apartment-style resi 
dence, including balcony and swimming 
pool facing lake, adjacent to hospital. 

Apply: 
Director of Nursing 

GENERAL HOSPITAL 

Port Colborne, Ontario 



ST. JOSEPH S HOSPITAL 

LONDON, ONTARIO 

Teaching Hospital, 600 beds, new facilities 
requires : 

REGISTERED NURSES 
REGISTERED NURSING ASSISTANTS 

For further information apply : 

The Director of Nursing 

ST. JOSEPH S HOSPITAL 

London, Ontario 



McKELLAR GENERAL HOSPITAL 

requires 

Registered Nurses for general Staff. The 
hospital is friendly and progressive. 
It is now in the beginning stages of a 
$3,500,000 program of expansion and 
renovation. 

Openings in all services. 
Proximity to Lakehead University 
ensures opportunity for furthering 
education. 

for full particulars write to: 

Acting Director 
of Nursing Service 

McKELLAR GENERAL HOSPITAL, 
Fort William, Ontario. 



REGISTERED NURSES 

For new 100-bed General Hospital in 
resort town of 14,000 people, beautifully 
located on shores of Lake of the Woods. 
Three hours travel time from Winnipeg 
with good transportation available. Wide 
variety of summer and winter sports 
swimming, boating, fishing, golfing, skat 
ing, curling, tobogganing, skiing and ice 
fishing. 

Salary: $372 for nurses registered in 
Ontario with allowance for experience. 
Residence available. Good personnel poli 
cies. 

Apply to: 
DIRECTOR OF NURSING 

KENORA GENERAL HOSPITAL 

Kenora, Ontario 



DIRECTOR OF NURSING 
EDUCATION 

Master s degree preferred; to conduct 
basic nursing program and affilliate pro 
gram. 

Apply to: 

Director of Nursing, 
CHILDREN S HOSPITAL 

OF WINNIPEG, 
Winnipeg, Manitoba. 



ST. JOSEPH S HOSPITAL 

SCHOOL OF NURSING 
Hamilton, Ontario 

requires 

CLINICAL INSTRUCTORS in all Nursing 
areas. Well-equipped, modern School of 
Nursing. Student enrolment over 300. 
Modern, progressive, 800-bed Hospital. 
Salary commensurate with preparation 
and experience. 

for further details, apply: 
DIRECTOR OF NURSING 



OTTAWA CIVIC HOSPITAL 

OTTAWA, ONTARIO 

This modern 1087-bed teaching hospital 
requires: 

REGISTERED NURSES 

FOR ALL SERVICES INCLUDING 
OPERATING ROOM AND PSYCHIATRY 

Excellent salaries, personnel policies and 
fringe benefits are available. 

Apply in writing to: 

B. JEAN MILLIGAN, Reg. N., M.A. 
Assistant Director 



ST. THOMAS-ELGIN 
GENERAL HOSPITAL 

Requires 

GENERAL STAFF NURSES 
REGISTERED NURSING 

ASSISTANTS 
O. R. TECHNICIANS 

Modern 395 bed, fully accredited General 
Hospital opened in 1954, with School of 
Nursing. Excellent personnel policies. 
O. H. A. Pension Plan. Pleasant progres 
sive industrial city of 22,500. 

Apply: 

Director of Nursing, 
ST. THOMAS-ELGIN GENERAL 

HOSPITAL 
St. Thomas, Ontario. 



74 THE CANADIAN NURSE 



JANUARY 1967 



SUNNYBROOK 
HOSPITAL 

REGISTERED NURSES 

General Duty Nurses on rotating 
shifts are needed as part of the 
re-organization of Sunnybrook as 
a university teaching hospital. 
Employment in our Nursing Ser 
vices Department includes: 

Metro Toronto Salary Scale 
Accommodation at reduced 
rates. Full range of fringe 
benefits 

Three weeks vacation after 
1 year 

Good location bus from 
subway on to hospital 
grounds. 



For additional information, 
please write: 

Director of Personnel 
and Public Relations, 

SUNNYBROOK HOSPITAL 

2075 Bayview Avenue 
Toronto 12, Ontario 



POSITIONS ARE AVAILABLE 
for 

REGISTERED NURSES 



with special interest in medical 
nursing and rehabilitation of 
long term patients. 

Salaries recommended by the 
Registered Nurses 
Association of Ontario 

Inservice educational program 
me developed and 
expanding 

Residence accommodation avail 
able at a very mod 
erate rate 

Transportation advanced, if re 
quested 

Apply to: 
Director of Nursing 

THE QUEEN ELIZABETH HOSPITAL 

130 Dunn Avenue 
Toronto 3, Ont. 



REGISTERED NURSES 

for General Duty 

In modern 20-bed hospital locat 
ed in thriving northwestern On 
tario community. Starting salary 
$335 minimum to $400 maxi 
mum for three years experience. 
Board and room in modern 
nurses residence is supplied at 
no charge. Excellent employee 
benefits and recreational facili 
ties available. Further particulars 
on request. Apply giving full 
details of experience, age, avail 
ability, etc. to: 

Employment Supervisor 

MARATHON CORPORATION 
OF CANADA LIMITED 

Marathon, Ontario 



ONTARIO SOCIETY 

FOR 

CRIPPLED CHILDREN 




Invites applications from Public 
Health Nurses who have at least 
1 years experience in general 
ized public health nursing, pre 
ferably in Ontario. 

INTERESTING AND VARIED 

PROFESSIONAL SERVICES 

IN AN EXPANDING PROGRAM 

INCLUDE: 

an opportunity to work direct 
ly with children, their parents, 
health and welfare agencies, 
and professional groups 

participation in arranging 
diagnostic and consultant cli 
nics 

assessing the needs of the 
individually handicapped child 
in relation to services provided 
by Easter Seal Clubs and the 
Society. 

Attractive salary schedule with 
excellent benefits. Car provided. 
Pre-service preparation with sa 
lary. 



Apply in writing to: 

Director, Nursing Service, 
350 Rumsey Road, 
Toronto 17, Ontario 



ANUARY 1967 



THE CANADIAN NURSE 75 



REGISTERED NURSES 

Staff positions available in acute and 
convalescent unit of large General Hospital 
located in San Francisco Bay Area. Starting 
salary $550 to $605 plus differential. Ex 
cellent benefits. 



Apply: 

SEQUOIA HOSPITAL 

Whipple and Alameda 

Redwood City, California 



REGISTERED NURSES 

required for 

82-bed hospital. Situated in the Niagara 
Peninsula. Transportation assistance. 

For salary rates and personnel policies, 

apply to: 
Director of Nursing 

HALDIMAND WAR MEMORIAL 
HOSPITAL 

Dunnville, Ontario 



THE UNIVERSITY OF 
WESTERN ONTARIO 

SCHOOL OF NURSING 

announces 

FACULTY POSITIONS 

available for the following programmes: 

1. A Four- Year Basic Degree Programme 
(B.Sc.N.) beginning in September 1966 

2. Degree Programme for Graduate Reg 
istered Nurses. 

3. Expanding graduate programmes 
(M.Sc.N.). 

Enquires are invited from qualified person; 
who are interested in University teaching 
opportunities in the School of Nursing of a 
rapidly developing Health Sciences Centre. 

for information write to: 

The Dean, School of Nursing 

THE UNIVERSITY OF 

WESTERN ONTARIO 

London, Canada 



222 BED GENERAL HOSPITAL 

requires 

STAFF NURSES 
REGISTERED NURSING ASSISTANTS 

Cornwall is noted for its summer and 
winter sport areas, and is an hour and a 
half from both Montreal and Ottawa. 
Progressive personnel policies include 4 
weeks vacation. Experience and post-basic 
certificates are recognized. 

Apply to: 

Ass t. Director of Nursing 

(service) 

CORNWALL GENERAL HOSPITAL 
Cornwall, Ontario 



DIRECTOR OF NURSING 

Applications are invited for the above 
position in a modern, 56-bed, fully ac 
credited hospital with expansion plans 
under active study. Nursing administrative 
education and experience desirable. 
Salary commensurate with qualifications. 

Apply: 

Mrs. M. Fearn, Executive Director 
THE BARRIE MEMORIAL 

HOSPITAL 
Ormstown,, Quebec 



REGISTERED NURSES 

Positions available in several hospitals 
in East Central Saskatchewan ranging 
from 10-75 beds. Saskatchewan Reg 
istered Nurses Association salary schedule 
and personnel policies in effect. 

For further information apply to: 

Executive Director 

EAST CENTRAL REGIONAL 

HOSPITAL COUNCIL 

Suite 4, Smith Block, 

Yorkton, Saskatchewan 



EVENING OR NIGHT 
SUPERVISOR 

For 701 bed active hospital located 70 
miles East of Saskatoon. Salary com 
mensurate with experience and qualifica 
tions. Excellent personnel policies. 

Apply : 

Director of Nursing Service 

ST. ELIZABETH S HOSPITAL 

Humboldt, Saskatchewan 



CLINICAL INSTRUCTOR 
FOR OPERATING ROOM 

required by 

ROYAL COLUMBIAN HOSPITAL 

School of Nursing, 
New Westminster, B.C. 

For further information contact 
Director of Nursing 



GENERAL DUTY NURSES 

and 
NURSING ASSISTANTS 

Wanted for active General Hospital (125 
beds) situated in St. Anthony, Newfound 
land, a town of 2,400 and headquarters 
of the International Grenfell Association 
which provides medical care for northern 
Newfoundland and the coast of Labrador. 
Salaries in accordance with ARNN. 

For further information 
please write: 

Miss Dorothy A. Plant 

INTERNATIONAL GRENFELL ASSOCIATION 

Room 701 A, 88 Metcalfe Street, 

OTTAWA 4, ONTARIO 



76 THE CANADIAN NURSE 



JANUARY 1967 




GUY S HOSPITAL 
LONDON 

TO REGISTERED NURSES OF 
ACCREDITED SCHOOLS OF NURSING 



If you are visiting Great Britain, why not widen your professional 
experience and consider joining the staff at Guy s Hospital? 
Appointments for six months are offered in all Branches of general 
nursing, in the specialised units, and private patients wing. 
The furnished accommodation is excellent and all modern facilities 
are available. The Hospital is ideally situated for exploring London. 
Those nurses who are interested and would like further information, 
please write to: 

The Matron, Guy s Hospital, 
London, S.E.I. 

giving details of your nursing training, and subsequent experience. 



SCHOOL OF NURSING 

BROCKYILLE 
GENERAL HOSPITAL 

Requires 

TEACHERS 

For the recently approved two year curriculum with 
a third year of experience in nursing service. You 
will enjoy participating in the development of a 
progressive school which emphasizes planned learn 
ing experiences for the students. Theory is taught 
concurrent with clinical experience. 

Qualifications: Bachelor of Science in Nursing 

or Diploma in Nursing Education 
or Diploma in Public Health Nursing 

Excellent salaries and personnel policies. 

You would enjoy living in the attractive "City of 

the Thousand Islands" two and one half hours from 

Expo 67. 

For further information contact: 

The Director, School of Nursing 

BROCKVILLE GENERAL HOSPITAL 

Brockville, Ontario 




THE MONTREAL GENERAL HOSPITAL 

offers a 

6 month Advanced Course in 

Operating Room Technique and 

Management to 

REGISTERED NURSES 

with a year s Graduate experience 

in an Operating Room. 
Classes commence in September and 
March for selected classes of 
8 students 



For further information apply to : 
The Director of Nursing 

THE MONTREAL GENERAL HOSPITAL 

Montreal 25, Quebec 



IANUARY 1967 



THE CANADIAN NURSE 77 




REGISTERED & GRADUATE 
NURSES 

Are required to fill vacancies in a modern, centrally 

located Hospital. Tours of duty are 7:30 - 4:00, 3:30 - 

12:00 and 11:30-8:00. 

Salary range for Registered Nurses is $382.50 to 

$447.50 per month and for Graduate Nurses is 

$352.50 to $417.50 per month. We offer a full 

range of employee benefits and excellent working 

conditions. 

Day Care facilities for pre-school children from 3 

months to 5 years in age. 

Apply in person, or by letter to : 
Personnel Manager, 

THE RIVERDALE HOSPITAL 

St. Matthews Road, 
Toronto 8, Ontario. 



REGISTERED NURSES 

Lutheran General Hospital, Park Ridge, Illinois is a 
new 587-bed General Hospital, located in a pleasant 
suburb of Chicago. 

The hospital is modern with a wide range of services 
to patients, including Hyperbaric Oxygen Unit. Low- 
cost modern housing next to the hospital is available. 
The hospital is completely air-conditioned. 

Annual beginning salary is from $6,000 plus shift 
differential pay. Regular salary increments at six 
months of service and yearly thereafter. Sick leave 
and other fringe benefits are also available. 

Write or call collect: 
Director of Nursing Services 

LUTHERAN GENERAL HOSPITAL 

PARK RIDGE, ILLINOIS 60068 

Telephone: 692-2210 Ext. 211 
Area Code: 312 



DALHOUSIE UNIVERSITY 
offers 

NEW DIPLOAAA PROGRAM 
in 

OUTPOST NURSING 

A program extending over two calendar 
years has been developed to prepare 
graduate nurses for service in remote 
areas of Northern Canada. Major areas 
within the course of study will include : 

Public health nursing 

Complete midwifery 

Basic clinical medicine 
Instruction will be highly individualized. 
1st year To be spent at the University. 
2nd year To consist of an internship 
directed by the University in 
selected northern agencies. 
Candidates should have completed at 
least one year of professional nursing. 
Upon completion of the program students 
will receive a Diploma in Public Health 
Nursing and a Diploma in Outpost 
Nursing. 

for further information write to: 

Director, 
SCHOOL OF NURSING 

DALHOUSIE UNIVERSITY 

Halifax, Nova Scotia 



THE WINNIPEG 
GENERAL HOSPITAL 

Offers the following opportunity for ad 
vanced preparation to qualified Registered 
Graduate Nurses: 

A SIX MONTH CLINICAL COURSE 

in 

OPERATING ROOM 

PRINCIPLES AND ADVANCED 

PRACTICE 

The course commences in September of 
each year. Maintenance is provided, and 
a reasonable stipend is given each month. 
Enrolment is limited to a maximum of 
ten students. 

For further information please 
write to: 

THE DIRECTOR OF NURSING 

700 William Ave. 
Winnipeg 3 




DALHOUSIE 
UNIVERSITY 



Degree Course in Basic Nursing (B.N.) 
4 years 

A program extending over four calendar 
years leading to the Bachelor of Nursing 
degree is offered to candidates with a 
Nova Scotia Grade XII standing (or equiv 
alent) and prepares the student for nursing 
practice in hospitals and the community. 
The curriculum includes studies in the 
humanities, nursing and the sciences. 

Degree Course for Registered Nurses 
(B.N.) 3 years 

A program extending over three academic 
years is offered to Registered Nurses who 
wish to obtain a Bachelor of Nursing 
degree. The course includes studies in 
the humanities, sciences and a nursing 
specialty. 

Diploma Courses for Registered Nurses 
1 year 

(1) Nursing Service Administration 

(2) Public Health Nursing 

(3) Teaching in Schools of Nursing 

For further information apply to: 
Director, School of Nursing 

DALHOUSIE UNIVERSITY 

Halifax, N.S. 



78 THE CANADIAN NURSE 



JANUARY 196" 



UNITED STATES 



AFF NURSES --- Here is the opportunity to further 
velop your professional skills and knowledge in 
r 1,000-bed medical center. We have liberal personnel 
licies with premiums for evening and night tours, 
jr nurses residence, located in the midst of 33 
Itural and educational institutions, offers low-cost 
using adjacent to the Hospitals. Write for our booklet 
nursing opportunities. Feel free to tell us what type 
sition you are seeking. Write: Director of Nursing, 
om 600, University Hospitals of Cleveland, University 
rcle, Cleveland, Ohio 44-06 15-36-1 G 



gistered Nurse (Scenic Oregon vacation play- 
Dund, skiing, swimming, boating & cultural 
ents) for 295-bed teaching unit on campus of 
ijversity of Oregon medical school. Salary starts 
$525. Pay differential for nights and evenings. 



Liberal policy for advancement, vacations, sick 
leave, holidays. Apply: Multnomah Hospital, Port 
land, Oregon. 97201 . 1 5-38-1 



Staff Nurses: Live with your family in an attractive 
2 bedroom furnished home for $55 per month, 
including utilities, and work in a suburban Cleve 
land hospital. Starting salary range $420 $445 
with 6 and 12 month increments. Excellent transpor 
tation to hospital door. Outstanding schools and 
cultural opportunities. Apply: Director of Nursing 
Service, Sunny Acres Hospital, 4310 Richmond Road, 
Cleveland, Ohio 44122. 15-36-1 E 



GRADUATE NURSES Wouldn t you like to work 
at a modern 532-bed acute General Teaching Hos 
pital where you would have: (a) unlimited oppor 
tunities for professional growth and advancement, 
(b) tuition paid for advanced study, (c) starting 
salary of $429 per month (to those with pending 
registration as well), d) progressive personnel poli- 



ROYAL VICTORIA HOSPITAL 

SCHOOL OF NURSING 



MONTREAL, QUEBEC 



I POSTGRADUATE COURSES 

1. (a) Six month clinical course in Obstetrical Nursing. 

Classes September and March. 

(b) Two month clinical course in Gynecological Nursing. 
Classes following the six month course in Obstetrical 
Nursing. 

(c) Eight week course in Care of the Premature Infant. 

2. Six month course in Operating Room Technique. 
Classes September and March. 

3. Six month course in Theory and Practice in Psychiatric 
Nursing. 

Classes September and March. 



For information and details of the courses, apply to: 
DIRECTOR OF NURSING 

ROYAL VICTORIA HOSPITAL 

Montreal, P.O. 



cies, (e) a choice of areas? For further information, 
write or call collect: Miss Louise Harrison, Director 
of Nursing Service, Mount Sinai Hospital, University 
Circle, Cleveland, Ohio 44106. Phone SWeetbriar 
5-6000. 15-36-1 D 



STAFF NURSES: University of Washington. 320-bed 
modern, expanding Teaching and Research Hospital 
located on campus offers you an opportunity to 
join the staff in one of the following specialties: 
Clinical Research, Premature Center, Open Heart 
Surgery, Physical Medicine, Orthopedicts, Neurosur- 
gery, Adult and Child Psychiatry in addition to 
the General Services. Salary: $501 to $576. Unique 
benefit program includes free University courses after 
six months. For information on opportunities, write 
to: Mrs. Ruth Fine, Director of Nursing Services, 
University Hospital, 1959 N.E. Pacific Avenue, 
Seattle, Washington 98105. 15-48-2D 



UNIVERSITY OF 
BRITISH COLUMBIA 

School of Nursing 

DEGREE COURSE IN BASIC 
NURSING 

DEGREE COURSE FOR 
GRADUATE NURSES 

Both of these courses lead to the 
B.S.N. degree. Graduates are pre 
pared for public health as well as 
hospital nursing positions. 

DIPLOMA COURSES FOR 
GRADUATE NURSES 

1. Public Health Nursing. 

2. Administration of Hospital 
Nursing Units. 

3. Psychiatric Nursing. 

For information write to: 
The Director 

SCHOOL OF NURSING 
UNIVERSITY OF B.C. 

Vancouver 8, B.C. 



NOVA SCOTIA SANATORIUM 

KENTVIUE, N.S. 

Offers to Graduate Nurses a 
Three-Month Course in Tubercu 
losis Nursing, including Immu 
nology, Prevention, Medical and 
Surgical Treatment. 

For information apply to: 
Director of Nursing 

NOVA SCOTIA SANATORIUM 

Kentville, N.S. 



WUARY 1967 



THE CANADIAN NURSE 79 




Turns 

consume 

93 times their 

own weight 

in excess 

stomach 

acid! 



think how fast they ll work 
on your tummy upsets! 



Laboratory tests show Turns neu 
tralize 93 times their own weight 
in excess stomach acids, and that 
they maintain a balanced level for 
long periods, too. Turns go to work 
in 4 secondson gas, heartburn and 
indigestion. And they taste pleas 
antly minty, need no water and 
cost so very little. Those are the 
facts. So next time your tummy 
gives you a turn, give Turns a try. 
They re worth their weight in gold! 




FOR THE NURSE WHO 
DOESN T HAVE EVERYTHING 



ASSISTOSCOPE* 

When your friends start 
"fishing" for what to give 
you this Christmas, hint 
to them how much you 
would like your personal 
lightweight stethoscope. 



ASSISTOSCOPE* designed with the nurse in mind. 

Regularly $12.95, your Christmas stethoscope will cost 
you only $9.85 in your choice of white or black tubing. 
This offer expires December 24th. 




Also available in spe 
cial sister model which 
fits easily under the 
coif. 

ASSISTOSCOPE* 

Made in Canada 



Order trom\ 




WINLEY-MORRIS COMPANY LTD. 

SURGICAL INSTRUMENTS DIVISION 
MONTREAL 21 QUEIEC 

TRADE MARK 



Index 

to 

advertisers 

January 1967 

Abbot Laboratories Ltd. 1 

Ames Company of Canada Ltd. Cover IV 

American Sterilizer Company 1 1 

Bland Uniforms Limited 2 

Government of Canada, Dept. of Labour 9 

Canadian University Service Overseas 24 

M. J. Chase Co. Inc. 57 

Charles E. Frosst & Co. 10 

Hollister Limited 6 

Lakeside Laboratories (Canada) Ltd. 5 

Lewis-Howe Company (Turns) 80 

C.V. Mosby Co. 20, 21 

T.M. Pharmaco (Canada) Ltd. 17 

J.T. Posey Company 18 

The Queen s Printer 12 

Reeves Company 19 

Uniforms Registered Cover III 

United Surgical Corporation 17 

Warner-Chilcott Labs. Co. Ltd. 57 

White Sister Uniforms Inc. Cover II 

Winley-Morris Co. Ltd 80 



Advertising 
Manager 

Ruth H. Baumel, 
The Canadian Nurse 
50 The Driveway, 
Ottawa 4, Ontario 

Advertising Representatives 
Richard P. Wilson, 
219 East Lancaster Avenue, 
Ardmore, Penna. 19003 

Vanco Publications, 
170 The Donway West, 
Suite 408, Don Mills, Ont. 

Member of Canadian 
Circulation Audit Board Inc. 



80 THE CANADIAN NURSE 



JANUARY 1%: 



February 1967 



-3ITY I p 

sc; 

HIT. 



TO . 



. T ... TO/. A 



The 



Canadian 
Nurse 

Ju 



w/ 




nursing in the USSR 
drug addiction 

nurse and pharmacist 
- partners 

estrogen and the menopause 



1 



i l 



Three outstanding professional fashions from Wl Cj SIS I LJ[\ 



#3632 




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This tucked bodiced professional s collar Is 
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#3632 in Sanitized Fortrel & Cotton Intimate 
Blend at $14.98 
with 3/4 roll-up sleeves, sizes 10-44 



This professionals bow is detachable 
#3698 in Sanitized Fortrel & Cotton Intimate 

Blend at $13.98 
#3998 in Sanitized Corded Tricot Knit Royale 

at $14.98 

#3598 in Sanitized Combed Wash & Wear 
"Shantung Weave" Poplin at $10.98 

all with 3/4 roll-up sleeves, sizes 10-20 









The Skinny Coat a professional look of fashii 



#3618 in Sanitized Fortrel & Cotton Intimate 



Blend at $13.98 



#3518 in Sanitized Combed Wash & Wear 



"Fancy Ottoman Weave" Poplin at $11.98 



both with 3/4 roll-up sleeves, sizes 8-11 




ORTREL . 
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Featuring one of White Sister s most beautiful new uniform fabrics. 

SANITIZED ORTREL & COTTON (65/35) INTIMATE BLEND. A most luxurious super-white- fabric 

in the smart Bengaline weave with superb wash-and-wear performance. 



These three exquisite White Sister luxury professionals seen here (and many others) are available at fine uniform shops and department stores everywhere. 
For the store nearest you, write: 



WH ITE SISTER 

70 MOUNT ROYAL WEST, MONTREAL, QUE. 



WHITE SISTER and THE CANADIAN NURSES ASSOCIATION 

are pleased to co-operate 

in the sponsoring jj^ TT Jt 

NURSES STATION 

at the 
MAN IN HEALTH PAVILION 



t?XL)OfY/ 





W.B. SAUNDERS COMPANY 

Philadelphia and London 



Sounders Texts to enrich and 
expand your knowledge of nursing . . . 

Kron Communication in Nursing 

By THORA KRON, R.N , B. S., formerly St. Luke s Hospital of Nursing. 
A New Book! From the author of Nursing Team Leadership, here 
is a practical guide for the nurse on how to write, speak even 
nod! with meaning. It skillfully shows how to have your thoughts 
and ideas "come accross." Mrs. Kron provides specific, how-to-do 
it information for achieving improved communication: how to 
become an intelligent listener -- how to give a demonstration - 
how to make a speech how to disagree agreeably how to 
write minutes, memos, reports, letters. In each discussion the author 
points out common difficulties and makes concrete suggestions for 
improvement. The principles given throughout the text are sum 
marized at the end. 244 pp., iltus., $4.05. Just Published! 

The Nursing Clinics of North America 

The Nursing Clinics fill an urgent need by providing a single and 
continuing source of information about the latest nursing concepts 
and techniques. The forthcoming March issue contains two impor 
tant symposia: The Nurse and the Law, with Jane C. Donahue, R.N., 
LL.B., as Guest Editor, and Radiation Uses and Hazards, with Eliza 
beth H. Boeker, M.S.P.H., as Guest Editor. The 16 full-length, well- 
written articles range from "Professional Liability Insurance for 
Nurses" to "Nursing Care in Radium Therapy." As in every issue of 
Nursing Clinics, every article is written by an authority in the field, 
and the topics discussed are those suggested by subscribers. Every 
issue (4 per year) contains about 160 pages with no advertising, 
and is bound between hard covers. Annual subscription (4 issues) 
only. $13.00. Student Rate: $10.80. 

Howe-Nutrition for Practical Nurses 

By PHYLLIS S. HOWE, B.S., M.E., Contra Costa College and Diablo 
Valley College. This up-to-date New (4th) Edition provides the 
practical nurse with full information on normal nutrition, diet 
therapy, plus selection and care of food. Discussions range from 
normal metabolic functions to the boiling temperatures for fresh 
vegetables- The author takes care to fully explain menu planning 
for both normal and special cases. You will find over 35 imme 
diately practical charts and tables on such subjects as: new storage 
times for frozen foods modified diet patterns, such as sodium 
or fat restricted percentages of nutrients derived from the 
basic four food groups fatty acid and cholesterol content of 
foods. Exercises are included at the end of most chapters. 302 pp., 
illus., $4.05. New (4th) Edition Just Published! 

Dennis- 
Psychology of Human Behavior for Nurses 

By Lorraine Bradt Dennis, B.S., R.N., M.S., Marymount Junior Col 
lege. In the thoroughly revised and expanded New (3rd) Edition! 

of this delightful book, Mrs. Dennis has achieved much more than 
just another textbook. As well as providing an excellent practical 
introduction to psychology, this books helps the student nurse to 
find out what she really wants to know: Why do people behave 
as they do? How can I study most effectively? What can I do 
about my problems? Mrs. Dennis gives a clear and balanced 
picture of psychology. She discusses genetics and early develop 
ment; learning, behavior, and personality; defense mechanisms,- 
mental illness and the forms of psychotherapy; emotional maturity 
in marriage all with wit, warmth, and wisdom. Teacher s 
Guide available. 289 pp., illus., $5.40. New (3rd) Edition Just 
Published! 



Canadian Representative: Me Ainsh and Company, Ltd. 1835 Yonge St., Toronto 7 

BRUARY 1967 THE CANADIAN NURSE 1 



so soft ... so soothing 








SOME STYLES ALSO AVAILABLE IN COLORS ... SOME STYLES 3jf12 AAAA-E. $15.95 to $20.95 

For a complimentary pair of white shoelaces, folder showing all the smart Clinic styles, and list of stores selling them, write: 

THE CLINIC SHOEMAKERS De pt.CN-2. 1 221 Locust St. St. Louis, Mo. 631 03 
2 THE CANADIAN NURSE FEBRUARY 1967 



The 

Canadian 
Nurse 



A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses Association 




Volume 63, Number 2 



27 A Glimpse of Nursing in the USSR 
34 Estrogen Replacement at Menopause 
38 Estrogen and the Menopause 



February 1967 



H. K. Mussallem 

D. C. McEwen 

J. Blanchet 



40 Nurse and Pharmacist Partners J. L. Summers 

45 Tumors of the Skin P. J. Fitzpatrick 

48 Radiation Therapy for Skin Cancer D. Martyn 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses Association. 



4 Letters 

7 News 
18 Names 
21 Dates 

Cover photo courtesy of the USSR Embassy 



23 In A Capsule 
25 New Products 
51 Books 

54 Films 

55 Accession List 



Executive Director: Helen K. Mussallem . 
Editor: Virginia A. Ltndabury Assistant 
Editor: Glennls N. Zllm Editorial Assistant: 
Carla D. Penn Circulation Manager: Pier 
rette Hotte . Advertising Manager: Ruth H. 
Baumel . Subscription Rates: Canada: One 
Year, $4.50; two years, $8.00. Foreign: One 
Year, $5.00; two years, $9.00. Single copies: 
50 cents each. Make cheques or money orders 
payable to The Canadian Nurse Change of 
Address: Four weeks notice and the old 
address as well as the new are necessary. Not 
responsible for journals lost in mail due to 
errors in address. 
Canadian Nurses Association, 1966 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
Authorized as Second-Class Mail by the Post 
Office Department, Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4. Ontario. 



iBRUARY 1967 



"The menopause is definitely 
obsolete today." 

This statement is from the pen 
of Robert A. Wilson, M.D., one of 
the best known proponents of 
estrogen replacement therapy for 
menopausal and postmenopausal 
women. 

Dr. Wilson and his group regard 
the menopause as a deficiency 
disease, rather than as an inevitable 
and irreversible condition. They 
believe it requires replacement 
therapy with hormones, just as 
diabetes mellitus requires insulin, 
and hypothyroidism, thyroid. 

Not all physicians agree with Dr. 
Wilson and his colleagues. Some 
strongly oppose the use of sex 
hormones to relieve menopausal 
symptoms. They defend this 
conservative position by saying that 
most of these symptoms result 
from psychic, rather than physical 
causes, and that the loss of female 
hormones at middle life is a normal 
phenomenon to which the body 
will adjust. 

Other physicians assume a 
moderate position, agreeing that 
hormone replacement is warranted 
when the vaginal cell count reveals 
estrogen deficiency, or when 
menopausal symptoms, such as hot 
flashes, backache due to 
osteoporosis, etc., become 
distressing to the patient. 

Many women, aware of the 
present controversy surrounding 
this topic will direct their questions 
to nurses. We can answer these 
questions objectively only if we 
have all pertinent facts. For this 
reason, we asked two gynecologists 
to present the pros and cons of 
estrogen replacement therapy. 

Dr. Donald C. McEwen, in 
"Estrogen Replacement Therapy at 
Menopause," claims that one 
woman in three suffers from ovarian 
deficiency and should be given 
estrogens for the balance of her life. 

Dr. Jean Blanchet, in "Estrogen 
and the Menopause," takes a more 
conservative approach. He believes 
that only a small percentage of 
menopausal patients have symptoms 
that warrant hormonal therapy. 

Whether or not the menopause 
becomes "obsolete" in future is not 
something that we can predict. 
However, with society s stress on 
youth and youthfulness it seems 
likely that we will hear more from 
the proponents of estrogen 
replacement therapy in the future. 

THE CANADIAN NURSE 3 



letters { 



Letters to the editor are welcome. 

Only signed letters will be considered for publication 

Name will be withheld at the writer s request. 



Recommended reading 

Dear Editor: 

We were interested in the review of 
Joyce Travelbee s Interpersonal Aspects of 
Nursing (December 1966). Our first-year 
students have been discussing material 
from this text frequently in their course in 
nursing fundamentals and we have found 
the book has helped them to think and 
understand more about nursing, human 
beings, and human experiences such as 
illness and suffering. Although there are 
a few deficiencies in the text, we believe 
that these are greatly outweighed by its 
value in assisting nursing students "to 
achieve helping relationships with others." 
Sister Patricia Marie, (Mrs.) B. Jones, 
L. Devereux, and (Mrs.) S. Dunning, 
Teachers of Fundamentals of Nursing, St. 
Joseph s School of Nursing, London, On 
tario. 



Dear Editor: 

I would like to recommend a book that 
I believe every nurse should read and 
which, I hope, she in turn may persuade 
just one doctor to read. 

The name is, In Search of Sanity, by 
Gregory Stefan, and is published by the 
University Books, New Hyde Park, New 
York. 

Those nurses who have read it say it is 
unbelievable. It is a very easily read book 
and I believe it is a very fitting successor 
to A Mind that Found Itself, by Clifford 
Beers, the old classic that did so much to 
change mental hospitals. 

Most book stores in large cities will order 
it; Book-of-the-Month will order it; and 
it is offered at a much cheaper price by 
The American Schizophrenic Foundation, 
Ann Arbor, Michigan, if one is a member. 
(Mrs.) Marion Palmer, Alberta. 



No criticism 
Dear Editor: 

In your November 1966 issue there was 
an interesting letter from a distressed 
reader regarding her obstetrical care in 
an Ontario hospital with a comment from 
a Halifax nurse stating: "I don t know 
what hospitals are putting out for nurses 
these days." 

Recently, I had the privilege of enter 
ing a modern obstetrical hospital in Hali 
fax. The attention and treatment I received, 
from the first moment I entered the hos 
pital with my suitcase, until I left with my 
4 THE CANADIAN NURSE 



firstborn son, was the happiest experience 
of my life, and I cannot honestly criticize 
any phase of my hospitalization. 

My admission was quickly, quietly, and 
efficiently performed by a student nurse, 
who first introduced herself, and explained 
each procedure before she began the rou 
tine preparations. She took the time to help 
me with the breathing exercises with each 
labor pain, thus reinforcing the instructions 
I had received from my doctor prenatally. 
On transfer to the waiting or labor room, 
I received friendly, professional interest 
and care from both students and supervisor. 
At no time during the waiting period was 
there evidence of confusion; therefore, a 
feeling of confidence was transmitted to 
me and no panic or fear resulted. The 
case room nurse took the time to visit 
several times during the long night and 
informed me of my progress. When I was 
finally admitted to the labor room, I felt 
the staff were friends as well as capable, 
well-trained professional personnel. 

The postpartum and nursery care in this 
hospital were of the same high calibre. My 
questions regarding the baby s progress 
as well as my own were quickly answered. 
The staff certainly displayed patient in 
terest during my hospital stay. 

After leaving the hospital, I felt sorry 
that I had received my training 15 years too 
soon, when the emphasis was on nursing 
service, with nursing education second. I 
believe that students today are receiving 
better education. They are given the op 
portunity to provide nursing care, instead 
of orderly, maid or technician duties. 

I enjoy the articles published on hospital 
nursing. However, I would like to see some 
articles on public health nursing. - - A 
Public Health Nurse, Nova Scotia. 



Obstetrics for men 

Dear Editor: 

I am writing to commend you on the 
article "Why Not Obstetric Nursing For 
Male Students?" (October r966). The 
article was short but presented a good ar 
gument in favor of obstetrical training for 
male nursing students. The same desires 
that bring women to nursing also bring 
men and the same opportunities for train 
ing should be available to both. I believe 
that having men in obstetrics could pos 
sibly lend a sense of stability and security 
to childbirth for many mothers. Marsha 
Smith, S.N., Providence School of Nursing, 
Sandusky, Ohio. 



University education 

Dear Editor: 

After reading Miss Margaret Steed s arti 
cle "A Goal for the Future," (Decembei 
1966) we would like to express our view 
points. 

First, we found the article very interest 
ing. We really appreciated Miss Steed : 
analysis of the different roles in the nursinf 
profession. Rather than being based or 
quantity, as in the past, nursing care will 
in the future, be viewed more from th 
aspect of quality. This will provide a new 
concept of nursing service a team work 
ing together, centered on the needs of the 
patient. 

For this, the hospital administrator will 
have to be well informed of the necessit) 
to employ and to utilize the work potential 
of the two different categories of nurses 

We questioned the guidance which should 
be given to candidates for either nursing 
course. Students must know exactly the 
kind of role for which they will be educ 
ated and the opportunities they will have 
to pursue their studies. We foresee how 
difficult it will be for a diploma nurse 
to be accepted in a baccalaureate program 
after following a non-credit nursing course 

Though it may be a distant goal, we 
should prepare the public, teachers, and 
students, to participate in the reorganiza 
tion of the nursing profession. 

Miss Steed really opened the way, and : 
we are looking forward to more articles 
in the same light. Nicole Lambert, Gi- 
nette Lefebvre and Louise Poirier, 4th 
year students in the baccalaureate pro 
gram, Institute Marguerite d Youville, 
Montreal. 

Dear Editor: 

I want to congratulate Miss Margaret 
Steed on her very fine article, "A Goal 
for the Future" (December, 1966). 

I have read this article with much in 
terest and believe that she has made many 
comments which present her true thoughts 
on nursing at the present time. 

In the section "Education for Practice," 
which is well outlined, she presents facts 
that should be a stimulus to many young 
nurses who wish to map out a goal for 
their future. In the paragraph "Distinctions 
in Role and Practice," she has endeavored 
to bring out the full meaning of the im 
portance of the nurse in practice. I was 
very interested in her comment on team 
nursing. 

The final paragraph, entitled "The Way 

(Continued on page 6) 
FEBRUARY 1967 




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ulcers. In short, Dermassage is "the topical tranquilizer". . . it relaxes the patient 
. . . helps make his hospital stay more pleasant. 

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: EBRUARY 1967 



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THE CANADIAN NURSE 5 



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letters 



(Continued from page 4) 

Ahead," is brief, concise, and very thought 
provoking. 

I will recommend this article to be read 
by all the students and I am very happy 
that she has taken her pen and com 
posed such a splendid article. Rahno 
M. Beamish, Director of Nursing, Kit 
chener-Waterloo Hospital. Kitchener, Ont. 

Dear Editor: 

The December issue, which describes bac 
calaureate education, contains information 
which is of great value for the recruitment 
and dissemination of information to the 
members of the profession. 

We were a little disappointed with the 
writeup given to Mount Saint Vincent Uni 
versity. When the original draft was sent 
for our review and correction in September, 
we made several changes. Yet, the uncor- 
rected draft appeared in the journal. We 
bring this to your attention knowing that 
THE CANADIAN NURSE, as the official organ 
of the Association, endeavors to publish 
accurate and up-to-date information. 

We look forward to each new edition of 
the journal for the stimulating and varied 
articles it contains. -- Sister Jean Eudes, 
R.N., M.S., Director of Nursing. 

The correct description of Mount Saint 
Vincent University is provided here for the 
benefit of readers. The Editors. 

Mount Saint Vincent University is the 
only independent women s college in Cana 
da. It is a Catholic institution for the 
higher education of women and is cond 
ucted by the Sisters of Charity. Located in 
the village of Rockingham, about 20 min 
utes from downtown Halifax by car, the 
campus overlooks Bedford Basin. The Uni 
versity is growing rapidly; a new tower 
residence and a Student Union building 
have been completed recently. Plans are 
under consideration for a new academic 
building with adjacent professional build 
ings. Sister Jean Eudes, Director of the 
School of Nursing, is responsible to the 
Academic Dean who, in turn, reports 
directly to the President of the University. 

The basic nursing program is a four- 
year, integrated program leading to a 
Bachelor of Science in Nursing (B.Sc.N.) 
degree. Mount Saint Vincent University 
was the first university in Nova Scotia to 
offer an integrated nursing degree pro 
gram. The course includes three summer 
sessions. Hospital practice is given in Hali 
fax hospitals and health agencies and is 
under the direct supervision of the Uni 
versity nursing faculty. 

A degree program is also open to reg 
istered nurses who have completed one- 
year university courses in a nursing special 
ty. The nurse who registers in this program 



6 THE CANADIAN NURSE 



is required to complete 10 courses ii 
science and liberal arts subjects. The pro 
gram, instituted to meet a pressing need fo 
nurses with degrees in administrative an, 
teaching positions in Nova Scotia, will b 
offered for a limited time. No certificat 
courses are available. 

Admission requirements to the basic 4* 
year integrated program include Senio 
Matriculation (Nova Scotia grade 12) wit, 
certain specific high school subjects. A ne\ 
tower residence with single room accom 
modation is available on campus and stu 
dents may live in if they so desire. Marrie, 
women may apply, and, although the Urn 
versity is primarily for women, men ma 
apply for certain courses. 

About 20 students are admitted to eaci 
new class. It is anticipated that the Schoc 
will enlarge its facilities. Interested cand, 
dates should write to the Director, Schoc 
of Nursing, Mount Saint Vincent Univer 
sily, Halifax, N.S. 

"Crumps!" 

Dear Editor: 

Why is it that you always publish letter 
saying what a good magazine you have 
Doesn t anyone ever say anything critical 

Every issue it s "bouquets" and "com 
pliments." Why don t we ever see "gai 
bage" and "grumps"? 

Maybe it s because readers like mysell 
who see plenty to criticize, get in the hab 
of tossing your magazine into the wasti 
basket and turning to the funny papers foi 
our amusement. 

Not that THE CANADIAN NURSE isn t amus 
ing at least to a certain extent. 

The bombastic, amateur-psychologist pros 
is really quite a laugh, as long as one doesn 
read too much of it or take it too seriousl} 
Take this, for a representative exampK 
from your last issue: 

"An analysis of the aspects of the nursin 
process as related to patient care reveal* 
a range of activities extending along 
continuum from the simplest to the mo 
complex." In other words, in treating pi 
tients, a nurse has easy jobs and har* 
ones. 

You ve been preaching higher educatio 
for some time in fact it seems to be th 
major theme of your magazine -- but 
Miss Margaret Steed s article (which 
quoted from) is an indication of what hap 
pens after higher education, then heave 
preserve us from it. 

I have one more grump. One gets ver 
tired of seeing, hearing, and reading aboi 
professionalism, and what behavior can b 
classified as professional, and is nursing 
profession or is it not. A nurse is a nursi 
and whether she belongs to a profession c 
a labor force, she s got to do the sam* 
things when she goes to work. What i 
fact you re talking about is status; which 
to say, you re encouraging snobbery, nt 
professionalism. Sharon Johnston, R.N 
Montreal, Quebec. 

FEBRUARY 1% 



news 



vtore Cooperation 
IMA-CNA-CHA 

The Canadian Medical Association has 
<een asked to form a steering committee 
o prepare for a conference on Hospital- 
vledical Staff relationships. The CMA 
vill invite the Canadian Nurses Associa- 
ion and the Canadian Hospital Association 

name members to the committee. 

The main object of the conference would 
>e to explain the place and role in the 
lospital of administrative personnel, med- 
cal staff, and nursing staff, and to em- 
ihasize the relationship between the three, 
lointing out the essential need for com- 
ilete understanding and cooperation to 
irrive at the desired result of more ef- 
icient operation to produce the best quality 
)f patient care. 

The conference was suggested by a joint 
:ommittee of the CHA, CMA, and CNA at 

1 meeting in December, 1966. 

The joint committee has also recom- 
nended that the three national associations 
>e given the opportunity to participate in 
ach other s annual or biennial meetings. 
)r. L.O. Bradley, of the CHA, stated that 
here is very little cross representation at 
innual meetings of either the national 
jr the provincial associations and that 
vhen such representation existed it was 
.eldom that the representatives were given 
in opportunity to report the activities of 
heir associations or to point out the pro- 
)lems that may exist between the organiza- 
ions. 

itudy on Non-Nursing 
Activities in B.C. 

"In determining the number of hours of 
lursing care per patient day, many hos 
pitals do not exclude the time spent by 
lursing staff performing duties that are 
Bore correctly the function of other depart 
ments." 

This is the conclusion of a joint com- 
nittee of the Registered Nurses Associa- 
:ion of British Columbia and the B.C. 
Hospital Association who have recently 
:ompleted an investigation of some of the 
areas in which nurses assist. The commit- 
ee consulted representatives of dietary, 
lousekeeping, pharmacy, laboratory, x-ray 
ind social service and have published a 
iix-page booklet outlining non-nursing 
luties that nurses are called on to assume 
n these areas. 

The committee has recommended that 
each hospital give serious consideration 
:o the question of whether nursing person- 

FEBRUARY 1967 



RN is Expo 67 Hostess 




This patient at the Montreal Protestant 
Hospital is being taken on a verbal tour 
of Expo 67 by a hostess who is quite at 
home at the hospital bedside. Barabara F. 
Stewart, a graduate of The Montreal Gen 
eral Hospital and the McGill School for 
Graduate Nurses, is one of the Expo 67 
hostesses who is presently informing North 
Americans about the coming Exposition. 

Miss Stewart, who speaks English, 
French and Italian fluently, was employed 
with the Montreal Branch of the Victorian 



. 



Order of Nurses prior to joining the Expo 
staff. Her wide professional experience at 
hospitals in Montreal, Atlanta, Georgia, 
Lausanne and Geneva, Switzerland, and 
her travels in 16 other countries give her 
a valuable background for meeting the 
persons of various ethnic groups who will 
attend Expo, April 28 to October 27. 

"Being hostess at Expo is a once-in-a- 
lifetime event," says Miss Stewart. "When 
it is over, I plan to return to nursing, 
since it is my-true metier." 



nel are being utilized to the best advantage, 
and when nursing personnel must be as 
signed non-nursing duties, the time so 
spent be subtracted when computing the 
actual nursing time being spent on nursing 
care." 

The committee recognizes that problems 
may exist in other areas, such as clerical, 
portering, messengering, and so on, and 
will continue their investigations into these 
areas at a later time. 



SRNA Prepares Guide 
for Refresher Courses 

The Saskatchewan Registered Nurses 
Association released a new 12-page Guide 
for Refresher Courses for Inactive Nurses 
in December, 1966. The booklet will be 
used as a guide to establish programs to 



help inactive nurses return to nursing. 

The booklet was prepared by the SRNA 
Committee on Nursing Service. Nurses who 
have not been engaged in nursing for a 
period of five years or longer are required 
to have a refresher course before returning 
to practice, and the SRNA has undertaken to 
give direction and help with the organization 
of such a program through this means. The 
association will also assist in finding suitable 
staff to carry out the program to help in 
active nurses return to nursing. 

The Guide recommends that hospitals of 
not less than 30 beds and subject to appro 
val by the SRNA may set up programs. Fees 
paid for the course would generally make the 
programs self-supporting. The length of the 
experience would depend on the needs of the 
individual, but a minimum of 120 hours of 
selected and supervised practice over a 

THE CANADIAN NURSE 7 



news 



period of not more than 6 weeks is suggest 
ed. Approximately 30 hours of theory should 
be correlated with the practice. 

Guidelines for course content are also 
included in the booklet. 

United Nurses of Montreal 
Seek Accreditation 

The legal counsel for the newly-organized 
United Nurses of Montreal, Mr. Phil Cutter, 
has announced that the UNM will seek to 
obtain accreditation from the Quebec 
Labour Relations Board to negotiate as 
bargaining agent for the 28 Montreal hos 
pitals in which English-speaking nurses are 
in the majority. 

The general meeting, in setting up the 
constitution, stipulated that all nurses who 
are English-speaking members of the ANPQ 
could join the UNM. In fact, the UNM 
was founded following a meeting of the 
English-speaking chapter of district 1 1 at 
which 1,200 nurses resolved to form a union 
to negotiate on working conditions. 

At a meeting of some 600 nurses on 
December 14, Miss Moyra Allen, instructor 
at the McGill School for Graduate Nurses 
and president of the English-speaking 
chapter of District 1 1 of the Association of 
Nurses of the Province of Quebec, was 
elected president of the UNM. Other offi 
cers elected were: Miss Terry MacMillen, 
vice-president; Miss L. Short, secretary; Miss 
C. Mutmuir, treasurer; and Misses T. Ni 
chols, M. Powers, and A. Hall, directors. 

At present the UNM has already recruited 
a majority of the approximately 4,800 
English-speaking nurses who work in the 
Montreal region. 

Another group of nurses, the Metropoli 
tan Association of Nurses, was formed in 
Montreal at the end of November, 1966, 
and is also seeking accreditation from the 
Labour Relations Board. 

Nurses Await Satisfactory 
Negotiations with Employers 

Ontario public health nurses in the coun 
ties of Halton, Stormont-Dundas-Glengarry, 
and Peel are still awaiting satisfactory 
outcomes to their negotiations with 
employers. 

In Halton County, the nurses returned 
to work on November 7th, with the verbal 
understanding that negotiations would start 
immediately on their return. On November 
23 the nurses learned that the Council had 
back-tracked on its promise. The County 
Council announced that it would not nego 
tiate with the nurses until they had become 
certified under the Labour Relations Act. 

The Halton County public health nurses 
are presently considering alternative courses 

8 THE CANADIAN NURSE 



of action. They have no immediate plans 
for certification. 

In the United Counties of Stormont- 
Dundas-Glengarry, the public health nurses 
returned to work on December 19, three 
months after handing in their resignations 
when employers refused to negotiate sala 
ries and working conditions with them. They 
returned to work with a written promise 
that a negotiating committee would be 
established, and that the board was prepared 
"to negotiate in good faith" with them. 

At press-time, no employer-employee ne 
gotiations had been initiated. 

In Peel County, which has also been grey- 
listed by RNAO, public health nurses are 
awaiting the report of a conciliator, who 
was appointed in November by the Ontario 
Labour Relations Board. It is probable that 
a conciliation board will be set up as a 
recommendation of this report. According 
to RNAO News, "the ability of Peel County 
Board of Health to negotiate in good faith 
has not yet been demonstrated and the 
situation is becoming critical." 

"No Smoking" Literature 
For Bedside Tables 

A joint committee of the Canadian Med 
ical Association, the Canadian Hospital 
Association and the Canadian Nurses As 
sociation suggested that the three associa 
tions should support the CMA campaign 
to publicize the harmful effects of smok 
ing. 

At a meeting early in December the com 
mittee agreed that the CMA, working with 
the Department of National Health and 
Welfare, was the appropriate body to notify 
the public of the health hazard from smok 
ing. 

It was also suggested that the CHA 
could recommend to hospitals that a notice 
prepared by the Department of National 
Health and endorsed by the CMA and 
CHA be placed on all bedside tables in 
hospitals. 

Hospital Fringe Benefits 
Below National Average 

In 1965, Canadian hospitals paid an 
average of $689 in fringe benefits for each 
employee. However, this was barely half 
the national average of $1,350 per employee 
of other Canadian industries. 

These figures were disclosed in the 
December issue of Hospital Administration 
in Canada, which pointed out that 20.8 
percent of total hospital payroll costs 
went toward fringe benefits. The overall 
national average of fringe benefits to pay 
roll is 25.2 percent. 

According to the article, the highest 
percentage of the fringe benefits given 
to hospital employees was for paid time 
off work. This was much higher than for 
any other group. Paid time off work in 



cludes vacation pay, holidays with pay* 
rest periods and coffee breaks, paid tim> 
off for death in the family, jury and militar 
duty. 

Hospitals rank very low in percentag. 
of payroll benefits devoted to unemploy 
ment and workmen s compensation and ii- 
contributary pension and other welfar 
programs in comparison to the nationa 
average. 

Hospitals ranked higher in other nont 
cash benefits, such as cafeteria losses 
medical supplies to employees, parking! 
education, and laundry services. 

The article was based on a study b 
The Thorn Group Ltd., managemeB 
consultants, Toronto. This was the firm 1 
sixth report on "Employer fringe benefi 
costs in Canada," but the first time tha* 
hospitals were included in the survey. 

National Health and Welfare 
The Year in Review 

The year 1966 was a year of hand 
across the sea and expanded social securit 
across the nation for the Department c- 
National Health and Welfare. 

On the international scene, the Emei 
gency Health Services Division sent 1M 
emergency hospitals to Viet Nam and Dr 
Joseph W. Willard, Deputy Minister Of 
Welfare, was elected chairman of th. 
Executive Board of UNICEF. 

In the field of social security, the newes 
development was the announcement of th- 
Guaranteed Income Supplement, whicH 
will provide up to $360 a year to aboi 
900,000 Old Age Security pensioners wit " 
modest or no other income. 

The major expansion of the department 
health facilities was completion of th* 
Environmental Health Centre in Ottawz 
opened officially in October by the Mi 
nister, Hon. Allan J. MacEachen. The nei 
building accomodates laboratories and o< 
fices of the Occupational Health Divisior 
the Public Health Engineering Divisio: 
and the Consultant in Aerospace Medicine 

The Medical Care Act was passed b 
Parliament at the end of the year and wil 
become operative not later than July 1 
1968. The provisions of this statute wer 
based on four principles outlined by th* 
Prime Minister in July, 1965, when he an 
nounced the government s intention t* 
make federal contributions for provincial! 
administered medical care programs avail 
able to the provinces. For provinces t* 
benefit from the federal program, provin 
cial plans must provide comprehensiv 
physicians services to all residents of th 
province without regard to age, abilit 
to pay or other circumstances. Further 
more, the Act empowers the governmen 
under stated circumstances to include add. 
tional health services. Provincial program 
must be publicly administered and bene 
(Continued on page 1C 
FEBRUARY 1%: 



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THE CANADIAN NURSE 9 



WORKSHOPS FOR 
DIRECTORS AND 
ASSISTANT DIRECTORS 



Six regional workshops for directors or assistant directors of nursing service in hospitals 
will be conducted in 1967. The topic: Improvement of Nursing Service in Hospitals Through 
the Problem-Solving Method. 

The workshops aim at stimulating directors and assistant directors of nursing service to use 
the problem-solving approach in the administration of nursing services. Key speakers will 
discuss techniques of problem-solving. Major problems in nursing services in Canada will be 
discussed. Through group work and case study methods skills in problem-solving will be 
developed. 

Two workshops will be held in the Spring: 
Region City 

Atlantic Halifax 

West Vancouver 



And four in the Fall: 

Region 

Ontario 

Mid-West 

Ontario 

Quebec 



Ci fy 
Toronto 
Regina 
London 
Quebec dry 



Dote 

April 11-14, 1967 
May 2-5, 1967 

Dote 

October 17-20, 1967 
October 24-27, 1967 
November 7-10, 1967 
Nov. 28-Dec. 1, 1967 



Exact locations will be announced later. 

The workshop to be held in Quebec city will be conducted in the French language only. 
English language nurses in the province of Quebec are invited to attend one of the work 
shops held in Ontario. French language nurses in New Brunswick are invited to attend the 
workshop in Quebec city. 

The workshops are open to directors or assistant directors of nursing service in hospitals. 
Registration is limited to 60 persons. The registration fee is $50.00. Because of the nature 
of the workshop only full-time registrants can be accepted. 

Here is an opportunity for directors and assistant directors of nursing service: 

to sharpen skills in problem-solving within a 
"training laboratory" environment; 

to learn how problem-solving can be facilitated through group work; 

to stimulate orderly thinking toward the improvement of 
nursing service; 

to identify the leadership role of the director of nursing service 
and/or assistant director of nursing service in problem-solving and 
decision making. 

Interested! then plan now to attend the workshop in your area. Register early and avoid 
disappointment. 

I wish to register for the CNA Regional Workshop for Directors or 
Assistant Directors of Nursing Service in Hospitals held in : 

G Halifax G Regina 

G Vancouver G London 

G Toronto G Quebec City 



Years in Position 
Number of Beds 



Name 

Title of Position 
Name of Hospital 
City or Town 
Qualifications beyond RN 

I enclose postal note (bank money order) for $ 
payable to the Canadian Nurses Association. 

MAIL TO: 

CANADIAN NURSES ASSOCIATION 

50 The Driveway 
Ottawa 4, Ontario 



news 



10 THE CANADIAN NURSE 



(Continued from page 8) 

fits must be portable from province tc 
province, thus ensuring the national char 
acter of the plan. The amount of the 
federal contribution will be based on the 
average cost of insured services in particip 
ating provinces and will be calculated on 
a per capita basis. 

Canada s need for more trained health 
personnel was recognized in July with the 
passage of the Health Resources Fund 
Act. It provides a fund of $500,000,000 
over 15 years to assist in acquisition, con 
struction, renovation and equipping of 
health training facilities and research insti 
tutions. The federal payments for any 
projects will be up to 50 percent of the 
total cost. The balance need not, as in 
some federal-provincial programs, be 
provided by the provincial government, 
but may be supplied by any source designat 
ed by the province. 

The Smoking and Health Program added 
two major weapons to its arsenal - - a 
teacher s kit with completely Canadian 
content and an animated film, The Drag. 
The film, directed at teenagers, is being 
given theatrical screening across Canada. 
A strong new link in the chain connecting 
smoking and fatal diseases such as lung 
cancer was forged by a recently published 
report of the department s Epidemiology 
Division. It gives the results of a study 
conducted from 1956 to 1962 on the mort 
ality rates of smokers compared to non- 
smokers. Those surveyed were recipients 
of pensions from the Department of Vete 
rans Affairs. 

The new Canada Assistance Plan is a 
federal-provincial measure designed to in 
tegrate existing public assistance programs 
and to share for the first time the cost of 
Mothers Allowances, health care, exten 
sions of welfare and administrative services, 
and work activity projects. The program 
places emphasis on the rehabilitation of 
recipients to overcome and reduce depen 
dency on assistance and represents a signi 
ficant step in updating and rounding out 
Canada s social security system. 

It was a year of intensive activity for 
the Canada Pension Plan. National head 
quarters in Ottawa and 37 district of 
fices across the country were established 
and began processing the first applications 
for retirement pensions, which started 
January, 1967. Services provided to the 
public by staff of these offices include: 
receiving applications for benefits, assist 
ing in the completion of applications, coun 
seling, explaining pension computations 
and furnishing other information on the 
Plan. 

(Continued on page 12) 
FEBRUARY 1967 



Making the Best Better 




New 7th Edition! 
TEXTBOOK OF ANATOMY 
AND PHYSIOLOGY 

Now in a new 7th edition, this highly successful text provides 
the basic facts and principles of body structure and function 
in a well-organized form. Student comprehension and interest 
are increased through the two-color format and the superb 
selection of illustrations, as well as the newly expanded full- 
color Trans-Vision insert. This new edition gives thorough 
coverage to the newer findings in all areas of anatomy and 
physiology, omits the abundant detail which tends to confuse 
students and places more emphasis on organizing facts about 
explicitly stated principles. New learning aids include a list 
of abbreviations widely used in physiology and a list of 
common prefixes in scientific words. A new test manual is 
provided without charge to all instructors who use this book 
as the required text. 

By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. Illustrated by ERNEST W. 
BECK. Publication dote: April, 1967. 7th edition, approx. 570 pages, 7" x 10". 
About $8.40. 

New 7th Edition! 
ANATOMY AND PHYSIOLOGY 
LABORATORY MANUAL 

The new 7th edition of this popular laboratory manual 
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suggests more audiovisual aids, includes chapter outlines and 
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charge to all instructors adopting this manual. 

By CATHERINE PARKER ANTHONY, B.A., M.S., R.N. Illustrated by ERNEST W. 
BECK. Publication date: May, 1967, 7th edition. About 14.00. 



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news 



(Continued from page 10) 

Catholic Nurses Meet 

The Association of Catholic Nurses of 
Canada, in conjunction with the National 
Council of Catholic Nurses of the United 
States, will host the North American 
regional congress. The congress will be 
held in Montreal June 20 to 22, 1967 within 
the framework of the Expo 67 theme. The 
congress theme will be "Suffering of Man 
and His World." 

His Eminence, Cardinal Leger, Father 
Tillard, O.P., and Dr. Eleanor C. Lamber- 
tson, dean of the faculty of nursing at Co 
lumbia University in New York, will be 
among the invited speakers. 

The program will include seminars as well 
as group meetings. An invitation to the 
congress is extended to Catholic nurses all 
over the world. 

Barrie Students Raise Funds 
for Overseas Student 

"Our Chinese Girl" is the favorite ex 
pression among nursing students at the 
Royal Victoria, Hospital in Barrie, Ont. 
Since Miss Catherine M. Brown, director of 
the Royal Victoria Regional School of Nurs 
ing, informed the students of a letter of 
application from Miss Cecilia Chiu, a For- 
mosan girl, the students have adopted a big 
sister attitude toward her. 

They have taken it upon themselves, as 
sisted by the Royal Victoria Hospital School 
of Nursing, to raise money to assist Miss 
Chiu with her entrance fees and expenses. 

Miss Brown received Miss Chiu s letter of 
application in July. Her academic standing 
was acceptable by provincial standards, and 
the young lady would have been accepted 
for the first class of the new regional school. 
However, the time-consuming factors of 
mail delivery overseas and the trip to Barrie 
would have made her arrive too late to 
enter that class. 

Miss Chiu, having been informed that the 
school entrance fee was $200, and knowing 
that she would need money to live on while 
in Canada, believed that she would need 
another $500. She mentioned in her letters 
that she had enough money saved for her 
passage to Toronto, and that she would 
keep her secretarial position in Formosa 
during this year, but she would still likely 
need financial help. 

It was at this point that the students 
began their money-raising campaign. The 
students have a permanent baby-sitting pro 
gram whereby one-half the money goes to 
the fund. They also have held a benefit 
dance, a hay ride, a hockey raffle and ;i 
hockey pool. Through the generosity of a 
local service station operator, the students 



held a gas-o-rama at which they received 
a commission on every gallon of gas they 
pumped. They have also received several 
offers of help and several donations from 
individuals in the area. 

To date, they have raised $336, with a 
goal of $500-$600. They are still looking 
for imaginative ways to raise the rest. 

When asked why they were doing this for 
a girl they had never seen, Miss Mary 
Ellen Empringham, chairman of the fund- 
raising committee replied: "Because she has 
made such an earnest effort to manage her 
passage here, we do not feel she should be 
deprived of her wish. We also believe that 
nurses are to help people and, even though 
we are far from being nurses, we believe this 
campaign, its challenge, and the accomplish 
ment of our goal will furnish a test of our 
qualities and characters as future nurses." 



New Method for 
Early Cancer Detection 

Investigations that began 10 years 
ago at the Royal Victoria Hospital in 
Montreal are leading researchers to believe 
that "heat pictures" or thermograms of 
the thorax could be the best method of 
detecting breast cancers, the commonest 
tumors in women. 

Detection of breast cancer at a very early 
stage is not usually possible by ordinary 
techniques. However, since at least 90 per 
cent of patients with breast cancer show ab 
normal temperature variations of 1C or 
more in the breast skin over the lesion, 
doctors feel that this sign should be ex 
ploited as for as possible. There is also 
evidence that the degree of malignancy is 
related to the degree of temperature eleva 
tion. 

Now, a Canadian breast surgeon, Ray 
N. Lawson, has developed a method of 
producing heat pictures of the thorax that 
clearly portrays these temperature varia 
tions. Dr. Lawson uses infra-red radiation 
devices plus a scanning or image-producing 
device that gives a two-dimensional map 
or thermogram. The device is similar to 
the radar screens used on ships or in air 
plane towers, except that it is sensitive to 
heat variations. 

Investigations are currently underway to 
engineer improved electronic gear for 
displaying temperature patterns. "At pre 
sent, military needs have a much higher 
priority than those of medical research," 
says Dr. Lawson. "Knowledge of certain 
new advances in thermal physics that would 
help advance our techniques is presently 
unavailable to medical researchers." 

Engineering research in thermal physics 
is also particularly costly. Since Novem 
ber, 1966, however, the American Cancer 
Society has been sponsoring a program to 
evaluate the use of thermography diagnosis 
in breast cancer, and some enthusiastic 
reports have already been given. 

FEBRUARY 1967 



news 



Using new techniques, scanning of large 
body surfaces takes less than a minute and 
permanent records of the area can be 
available for study 10 seconds after the 
scan. 

The new scanning techniques would also 
be applicable in other medical areas, such 
as placenta location in obstetrics, arthritic 
disease, dermatology and arteriosclerosis. 
It is now established in some clinics as a 
most useful aid in cancer detection, evalua 
tion of benign conditions, and follow-up 
surveys searching for cancer spread. 

Toronto s Street Haven 
Started by RN 

Street Haven, a refuge in Toronto for 
prostitutes, drug addicts, alcoholics, and 
lesbians, owes its existence to a thirty-year 
old registered nurse who has a big heart 
and a faith in human nature to match. 

Peggy Ann Walpole, a graduate of St. 
Michael s Hospital School of Nursing in 
Toronto, and now executive director of 
Street Haven, started this refuge for female 
offenders in March, 1965. At that time 
the Haven consisted of one room an 
unused beverage room in an old hotel 
and had no official financial backing. 

Today, as a non-sectarian organization 
that uses the services of more than 50 
volunteer workers, the Haven occupies 
2,000 square feet above a store in down 
town Toronto and contains bright, airy 
living rooms, an office, and a large kitchen. 
A monthly budget of $2.100 is made up of 
grants from the Alcoholism and Drug Ad 
diction Research Foundation, Eaton s, priv 
ate donors, and the United Church of 
Canada. 

The idea of establishing a refuge for 
women who are "at the bottom of the lad 
der" came to Miss Walpole after she had 
read The Junkie Priest, by Father Daniel 
Egan, founder of a similar haven in New 
York. Before reading this book, she had 
become convinced that something other 
than the usual halfway house was needed 
for women who had been caught in the 
web of narcotic addiction, prostitution, 
and petty crime. 

"No woman is an addict or a prostitute 
by nature," says Miss Walpole, who en 
countered many such persons as a nurse 
at St. Michael s, at a halfway house in 
Toronto, and at the city s Don Jail. "Usual 
ly she is pressured into the life. All too 
often she is released from prison without 
money, without worthwhile friends, with 
out a job, and with no place to go. When 
she returns to crime, it is for survival." 

The average age of the girls at the Haven 
is 23. Some come voluntarily for assistance, 
others are escorted by the police, or are 
FEBRUARY 1967 




Miss Peggy Ann Walpole, R.N., founder and executive director of Street Haven, 
a Toronto refuge for female offenders, chats with luncheon visitors in the 
Haven s public tearoom. Eaton s of Canada helped furnish this room. 



referred by the courts. Recently, two young 
girls were brought to the Haven by an old 
prostitute from a brothel where the girls 
had been living. 

At the Haven, the girls are accepted and 
given individual attention by Miss Walpole 
and her volunteers. The informal therapy 
consists of discussion groups, including 
Sunday evening sessions with young men 
from a Youth Anonymous group from 
Hamilton; recreational activities, such as 
bridge, ping-pong, darts, and a weekly 
hootenanny; instruction in the techniques 
of serving and cooking for Street Haven s 
tearoom, which is open to the public; and 
arts and crafts. Some girls are directed to 
adult retraining centers for clerical courses; 
others are assigned small housekeeping 
responsibilities in the Haven. 

The volunteers, all of whom are inex 
perienced when they come to Street Haven, 
involve themselves in all aspects of work. 
They write to and visit girls who are in 
hospital and jail; arrange to meet them on 
discharge from jail; pick up donations of 
furniture and clothing; assist with secre 
tarial work; go on emergency calls to hos 
pitals, and often to the "corners"; and 
attend court sessions. 

Nurses interested in volunteer work at 
the Haven should write: Street Haven, 2 
Teraulay Street, Toronto, Ontario. 

B.G.H. Receives 
Building Grant 

The Belleville General Hospital has been 
awarded a federal grant of $995,900 for 
construction and renovation programs. 

The hospital will add a new wing to its 
present building to provide space for 293 
active treatment beds and 44 beds for the 
care of psychiatric patients. The wing will 
also contain new operating rooms, x-ray 
department, laboratories and other facilities. 



Renovations to be carried out in the 
existing north wing will provide for an 
86-bed chronic care unit. Other renovations 
will include improvements to nurses sta 
tions, the enlargement of the physiotherapy 
department, modernization of the laundry, 
and additional space for the kitchen. 

Work is already underway and is schedul 
ed for completion about November, 1967. 

New Services at 
L lnstitut Albert Prevost 

Since the beginning of December, 1 Institut 
Albert Prevost in Montreal has offered the 
Quebec population three new psychiatric 
services: a diagnostic center, a day-care 
center, and a center for disturbed adoles 
cents. This new undertaking aims to permit 
easier access by the public to specialized psy 
chiatric services. 

The diagnostic center permits centraliza 
tion of all applications for care. Immediate 
consultation is available for patients who 
come to the center and appointments will 
be made within 24 hours for those who tele 
phone. After a preliminary evaluation, 
patients can be directed to the appropriate 
services. The outpatient clinic will now be 
limited to treatment of ambulatory patients. 

The day-care center can accomodate 20 
persons. These come to the hospital several 
days each week from 9:00 A.M. to 4.00 
P. M. These patients are those who, follow 
ing hospitalization, require a period of 
adaptation to life outside the institution, 
those who need medical supervision, or those 
who do not need continuous hospital treat 
ment but who will benefit from institutional 
services on a day basis. Experiments in other 
centers have shown that hospitalization can 
be reduced and often avoided. Therapeutic 
techniques center around group therapy and 
activities. 

(Continued on page 14) 
THE CANADIAN NURSE 13 



news 



(Continued from page 13) 

The center for disturbed adolescents pro 
vides beds for 10 patients and is reserved 
for boys from 14 to 18 years. This service 
brings to 160 the number of beds for 
adolescents of both sexes in the Montreal 
region. The center is attached to the child 
psychiatry division. 

The outpatient clinic and the day-care 
center will eventually include adolescents of 
both sexes. 



Gynecologist s Claim Investigated 

An American gynecologist is being in 
vestigated by the U.S. Food and Drug 
Administration, according to Canadian 
Doctor, for claiming that oral contracep 
tives prevent menopause. 

Dr. Robert A. Wilson, of Brooklyn, 
New York, made the claim in his recently 
published book Feminine Forever. 

FDA spokesmen said the statement is 
being investigated to determine whether it 
extends beyond claims made for the con 
traceptives on labeling approved by the 
Administration. 

An advisory committee which recently 



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The patient should preferably be lying on the left side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. Left 
colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. If a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
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preparation for re-use. The complete FLEET ENEMA 
unit is simply discarded! 

Every special plastic "squeeze-bottle" contains 4|/2 
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14 THE CANADIAN NURSE 



completed a nine-month study of contra 
ceptives reported no data indicating that 
any of the oral type are effective in altering 
the natural history of patients. 

An assistant to the FDA Commissioner 
said the issue is "a very involved legal 
question." 

Metabolic Research Ward 
Opens in Winnipeg 

Winnipeg Children s Hospital, Manitoba, 
opened a new ward for the diagnosis and 
treatment of metabolic disorders in children 
in mid-January, 1967. 

By coordinating the efforts of medical 
and paramedical personnel, dietitians, bio 
chemists, pharmacists, nurses, occupational 
therapists, and social services, the metabolic 
ward will provide a complete range of 
services for both diagnosis and treatment of 
these disorders. 

The unit will also offer services on an 
outpatient basis, and conduct educational 
programs in the home management of meta 
bolic disorders. 

The diagnosis of metabolic disorders is 
often delicate and painstaking and requires 
the young patients to undergo series of 
tests including careful measurement of die 
tary intake and excretions. Apparatus for 
collecting specimens from young children 
plus storage facilities for these specimens 
will be standard equipment in the new ward. 

Of the more than 100 metabolic disorders 
that have been diagnosed, some are tern- 
porary while others require a lifetime ol 
treatment. By opening its new ward, the 
Winnipeg Children s Hospital is joining the 
fight to lower the death rate among children 
suffering from such diseases. 

Mrs. Manfred Jager, appointed head 
nurse on the ward, prepared for her new 
position by inspecting metabolic wards in 
Toronto, Boston, and Montreal. Mrs. Jager 
a graduate of the Winnipeg Children s Hos 
pital, worked there as staff nurse and assis 
tant evening supervisor, and assisted in esta 
blishing a day hospital for children at the 
Mount Carmel Clinic in Winnipeg. 

The ward, to be located in the "four south 
section of the hospital," will be specially 
equipped with both the personnel and appa 
ratus necessary to diagnose the disorders. 

No Gyn on Obs! 

New Jersey has stopped hospitals in that 
state from combining the care of obstetric 
and gyneologic patients on the same nursing 
unit, according to an item in RN. 

The December issue of the nursing, 
magazine reported that a three-year pilot 
study had been stopped by the state be 
cause the hospitals involved in the research 
often violated the strict rules governing 
the admission of gyneologic patients to 
the maternity floors. "If pilot hospitals 
under close check ignore such criteria, 
other hospitals are even more likely to do 
so," said one state official. 

(Continued on page 16) 
FEBRUARY 1967 





GO!... Where the ACTION is! 

Albany Medical Center, that s where. A modern teaching hos 
pital perfectly located in beautiful upstate New York ... on 
the doorstep of New York City s bright lights . . . exciting 
horse racing at Saratoga . . . summer homes of the Philadelphia 
and Boston Symphony Orchestras . . . scenic Lake George . . . 
and the greatest skiing in the East. 

Our nursing opportunities are tops, too. For details, send for 
our free booklet, "Albany Medical Center Nurse." 

Albany Medical Center Hospital 

: EBRUARY 1967 



Mrs. Helen Middleworth, Director, Nursing Service 
Albany Medical Center Hospital 
Albany, New York 12208 

Please send me a free copy of your nursing booklet. 



NAME 



ADDRESS 



CITY 



.STATE ZIP CAN 

THE CANADIAN NURSE 15 



MOVING 



DON T FORGET YOUR 
CHANGE OF ADDRESS 

Name: 



Registration No.: 

(If registered in two provinces, 
please give both.) 



Province: 



Old Address: 



New Address: 



Date effective: 



Allow at least six weeks 
for change of address 

Mail to: 

The Canadian Nurse 

50 the Driveway 
Ottawa 4, Ont. 



news 



(Continued from page 14) 

"Operation Hospital Supplies" 

Health Minister M. B. Dymond has an 
nounced plans for Ontario s Department of 
Health to provide equipment for West Indies 
hospitals. The project will be known as 
"Operation Hospital Supplies." 

Dr. Dymond revealed that several weeks 
ago his Department had initiated a survey 
throughout general and psychiatric hos 
pitals in Ontario to ascertain what surplus 
equipment is on hand for disposal. Corres 
pondence with the Ministers of Health of the 
West Indies had previously revealed that 
most of the island hospitals lack many 
pieces of equipment that Canadians asso 
ciate with a well-run hospital. 

"Early survey returns received from a 
few hospitals here in Ontario have been 
more than gratifying," stated Dr. Dymond. 
"I am confident Operation Hospital Supplies 
will prove to be a highly successful project 
and most helpful to the people of the Carib 
bean. I feel all Canadians can share a 
sense of pride in the knowledge that a 
Centennial project of this nature will add 
to the health and well-being of their less 
fortunate Commonwealth partners," he ad 
ded. 

Equipment such as beds, bedpans, tables, 
trays, kidney basins is being requested. All 
Ontario hospitals, including their medical 
and nursing staffs have been inviled to sup 
port Operation Hospital Supplies throughout 
1967. 

RNAO Recommends Change 
In Public Health Act 

An amendment to Ontario s Public 
Health Act was one of the recommenda 
tions submitted by the Registered Nurses 
Association of Ontario to the provincial 
government s Committee on the Healing 
Arts last December. 

RNAO recommended "that the Public 
Health Act be amended to ensure that 
nursing service provided by public health 
nurses be an integral part of any public 
health unit." The present Act allows a 
public health unit to function with the 
provision of nursing services to the com 
munity. This, in effect, means that the 
community is not guaranteed the services 
of public health nurses. 

In addition to denying the community 
of nursing services, this omission in the 
Act has another ramification, according 
to the RNAO brief. "There are implica 
tions for public health nurses who might 
wish to become involved in negotiating 
with their employer, as it is quite within 
his rights to discontinue public health nur 
sing services without closing down the 
unit." 



16 THE CANADIAN NURSE 



ICN Council of International 
Representatives to Meet in July 

The Board of Directors of the Interna 
tional Council of Nurses discussed the 
tentative agenda for the meeting of the 
Council of National Representatives to be 
held June 26 to July 1, 1967 at Evian, 
France. The agenda includes suggested 
plans for the next ICN Quadrennial Con 
gress to be held in Montreal in July, 1969. 

The executive director and the president 
of the Canadian Nurses Association will 
attend on behalf of Canada. The other 63 
member countries are expected to send 
representatives also. 

At this meeting the theme for the 1969 
Congress will be chosen. Seventeen national 
member associations, including Canada, have 
submitted suggested themes. The subjects 
reflect the wide concern of the associations 
for the adaptation of nursing to the tech 
nological age and their interest in nursing 
research and nursing administration. 

Pharmaceutical Firm Expands 

Construction of a new wing is well under 
way at The British Drug Houses (Canada) 
Ltd., and the building is scheduled for 
completion in early 1967. Twelve thousand 
square feet on two floors are being added 
to the existing plant in surburban Toronto, 
at a cost of $750,000. 

The increased laboratory facilities will 
enable BDH to play an even greater part in 
research and development of medical pro 
ducts, laboratory chemicals and general 
chemicals, according to Mr. F. Burke, 
managing director of the company. 

Winners Fly to 
Easter Island 

A jet trip to Easter Island is in the im 
mediate future for Mr. and Mrs. G.H. 
Pimm of 251 Park Road, Rockcliffe, Ot 
tawa. Mr. Pimm is the winner of the Easter 
Island contest mentioned in the August 
1 965 issue of THE CANADIAN NURSE. 

Purpose of the contest was to raise money 
to pay for trailers left on Easter Island by 
the Canadian Medical Expedition. 

In an article "Aku-Aku And Medicine 
Men" (August 1965), Carlotta Hacker, 
staff member of the expedition, explained 
how the trailers were left. During a two- 
month medical survey conducted on the 
island by Dr. Skoryna, the 37 team mem 
bers lived and worked in ACTA trailers 
which they donated to the Pascuenses on 
their departure "as a much-needed annex 
to the hospital and as a permanent biologi 
cal station." 

Following the article, a contest was an 
nounced to help pay for the trailers. By 
becoming an Associate of the Easter Island 
Expedition Society at the cost of $1.00, 
one became eligible for a free trip to 
Easter Island. 

Mr. Pimm and his wife, winners of the 
contest, will fly to the Island via Chile, by 
Canadian Pacific Airways. 

FEBRUARY 1967 




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callisfor"Stat." 
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AMES tests are easy to perform and require no elaborate 
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FEBRUARY 1967 



THE CANADIAN NURSE 17 



names 




On January 2, 
1967, Tatiana Labe- 
kovski will take up 
her duties as the first 
director of the new 
Cornwall Regional 
School of Nursing. 
Although the class 
rooms and residence 
of the new school 

are not yet under construction, Mrs. Labe- 
kovski s appointment will mean "the begin 
ning of a concentrated effort to get things 
ready for the new class," for September, 
1967. 

Mrs. Labekovski received her B.A. in 
philosophy and philology from the Uni 
versity of Belgrade, Yugoslavia, and con 
tinued on toward a medical degree until her 
studies were interrupted by World War II. 

After her arrival in Canada, she grad 
uated from St. Joseph s School of Nursing 
at Hotel Dieu Hospital, Cornwall, obtained 
her diploma in nursing education from 
Queen s University, and was a member 
of the teaching faculty at the Cornwall 
school of nursing for six years. 

In the past four years, Mrs. Labekovski 
has been assistant secretary, nursing edu 
cation and service at the Toronto head of 
fice of the Registered Nurses Association 
of Ontario. 

Mrs. Labekovski arrived in Cornwall 
late this December to "settle in before 
starting to work on her rather monumental 
task." 

All inquiries about the new school should 
be directed to the schools of nursing at 
either of the local hospitals. They will be 
collected and held there until Mrs. Labe 
kovski has set up her office procedures. 



At the end of November 1966, the 
Canadian Nurses Association in Ottawa 
welcomed two interesting visitors Miriam 
M. Hornsby-Odoi and Ah Foo Chong 
both on World Health Organization fellow 
ships. 

Mrs. Hornsby-Odoi, a native of Ghana, 
was awarded a six-month fellowship com 
mencing November 14, 1966, to study 
public health nursing administration in 
Canada and the United States. 

Since 1963 she has been principal public 
health nurse with the ministry of health 
in Accra, Ghana. 

Following her study, Mrs. Hornsby-Odoi 
plans to introduce and apply new practical 
ideas to improve the organization of public 

18 THE CANADIAN NURSE 



health nursing service in Ghana. 

Miss Ah Foo Chong, whose six-month 
award began January 3, 1967, is studying 
public health nursing administration at the 
University of California and in San Fran 
cisco, Minnesota, New York, Washington, 
Baltimore, and Canada. 

Since 1963 Miss Ah Foo Chong has 
served with the Ministry of Health, Kuala 
Lumpur, Malaya as principal matron. In 
this position she has administrative duties 
at national level and is responsible to the 
director of medical services for the develop 
ment and expansion of the health and 
medical nursing service and nursing train 
ing programs. 

The fellowship will provide "an op 
portunity to work with nurses who are res 
ponsible for the administration of public 
health nursing programs at the national, 
state, and local levels in the U.S. and Ca 
nada." On her return home, Miss Ah Foo 
Chong will be in a position to apply "new 
ideas in the development of these services, 
and to analyze the existing public health 
nursing services." 



Ramona Paplaus- 
kas-Ramunas, a na 
tive of Lithuania, has 
recently joined the 
editorial staff of 

L lNFIRMIERE CANA- 
DIENNE. 

Miss Paplauskas- 

*^._ Ramunas attended the 

University of Ottawa 

where she obtained her B.A. and B.Sc. in 
1961. After graduation, she gained five 
years experience as a publications editor 
with the Canadian Department of Agri 
culture. 

A member of various organizations, Miss 
Paplauskas-Ramunas has also held executive 
positions with the Ottawa Citizenship Coun 
cil, Canadian Industrial Editors Associa 
tion, and the Professional Institute of the 
Public Service of Canada. 



Recently appointed 
to the newly esta 
blished position of 
nursing advisor in 
public health psy 
chiatry for The On 
tario Hospital, King 
ston, was Helen Eliza 
beth Etherington. 

A graduate of the 










Mack Training School, St. Catharines, 
Ontario, Miss Etherington has also received 
postgraduate education in both public health 
nursing and administration and supervision 
in public health nursing from the Univer 
sity of Toronto, In 1963-64 she attended 
the McGill School for Graduate Nurses 
where she obtained a diploma in teaching 
and supervision in public health nursing 
with a major in psychiatric nursing. 

Her experience has included two years 
as a faculty member at The Ontario Hos 
pital School of Nursing, Kingston, and 
seven years in various public health nursing 
positions including that of supervisor of 
public health nursing with the department 
of health, Peterborough. 



Helen Jean Hanel, 

a 1953 graduate of the 
school of nursing at 
the Calgary General 
Hospital, recently as 
sumed her new posi 
tion as director of 
nursing at the Nanai- 
mo Regional General 
Hospital, Nanaimo, 
British Columbia. 

Prior to her new appointment, Mrs. 
Hanel worked at the Royal Inland Hospital, 
in Kamloops, B.C. as associate director of 
nursing services. Other experience includes 
two and one-half years as director of nur 
sing at the Union Hospital, Canora, Sas 
katchewan, and service as a general duty 
nurse in St. Paul s Hospital, Saskatoon, 
and the Union Hospital, Swift Current, 
Saskatchewan. 



Eno Maud Orr, 

director of nursing 
of the Ontario Hos 
pital, Brockville, On 
tario, for the past 35 
years, retired Decem 
ber 31, 1966. 

Mrs. Orr graduat 
ed from the Ontario 
Hospital School of 

Nursing, Toronto. In 1930 she was among 
the second class to graduate in nursing 
education from the University of Toronto. 
Before assuming her duties as director 
of nursing in Brockville, she was an in 
structor at the Ontario Hospital, Toronto. 
Almost 400 nurses have graduated from 
the school of nursing "which she shaped 
and kept vigorous through the many 
changes in nursing education." 

FEBRUARY 1967 



- . 



Barabora Ellemers 

has been appointed 
assistant superinten 
dent of nursing educ 
ation for the Saskat 
chewan Department 
of Education. 

A 1958 graduate 
of the school of nur 
sing of the Regina 
3eneral Hospital, Mrs. Ellemers also ob- 
ained a diploma in public health nursing 
: rom the University of Saskatchewan, a 
6.N. from McGill, and is presently work- 
.ng toward her M.A. at the University of 
Saskatchewan. 

Prior to her present appointment, Mrs. 
Ellemers served with the Victorian Order 
3f Nurses, the Saskatchewan Department 
af Public Health, and the Regina City 
Health Department. She also worked at 
Ihe Jewish General Hospital in Montreal 
in 1962-63 as an instructor and during the 
following year as a lecturer at the McGill 
University School for Graduate Nurses. 



Valerie O Connor, former editor of the 
International Nursing Review, recently be 
came the new editor of Hospital World. 

Miss O Connor, awarded the Gilchrist 
Scholarship to study in Great Britain in 
1961, was the first Australian nurse to 
undertake an academic course in journalism. 
On completion of her studies at the Regent 
Street Polytechnic School of Journalism, 
she joined the editorial staff of Nursing 
Mirror. Subsequently she went to the Inter 
national Council of Nurses as public rela 
tions officer and editor of the Council s 
publication. 



Leila Raymond of the United Kingdom, 
has been appointed acting editor of the 
International Nursing Review. Until recent 
ly, Miss Raymond was clinical instructor 
at King s College Hospital, London, Eng 
land. 

She undertook her basic nursing educa 
tion at King s College Hospital; her post- 
basic nursing education includes a certifi 
cate for clinical instructor and teacher. 

She has been joint editor of the King s 
College Hospital Nurses League Journal, 
which appears annually. 



W.S. Hacon, former chief of the Emergen 
cy Health Services Division for the Depart 
ment of National Health and Welfare, reli- 
quinshed his appointment recently to accept 
a new position with the department. 

Mr. Hacon is the new director of Health 
Resources in the Department of National 
Health and Welfare. 

His successor in the Emergency Health 
Services has yet to be appointed. 

FEBRUARY 1967 




Georg Fei letter, for 
mer instructor at the 
Cornwall General 
Hospital School of 
Nursing, is the newly 
appointed assistant di 
rector of nursing (ser 
vice) at the hospital. 

Mr. Feilotter gra 
in 1 954 in his native 
Germany, and emigrated to Canada in 
I960. His first Canadian appointment was 
at the Victoria General Hospital in Win 
nipeg where he worked in medical-surgical 
nursing. From 1962 to 1964 he was a head 
nurse at the newly built Rehabilitation 
Centre in Winnipeg. 

Mr. Feilotter next attended the Univer 
sity of Ottawa where he obtained two 
diplomas, one in rehabilitation nursing and 
the other in teaching and administration. 
He is presently doing part-time study lead 
ing to his B.Sc.N. 

Mildred Irene Walker, who retired Novem 
ber 30, 1966 as senior nursing consultant in 
the occupational health division of the 
Department of National Health and Welfare 
(THE CANADIAN NURSE, January, 1967) died 
in hospital on January 16. 

Miss Walker began her nursing career in 
1924 with her graduation from the Victoria 
Hospital School of Nursing, London, On 
tario. Her busy career was largely adminis 
trative and included experience as a lecturer, 
assistant professor, and public health nurse. 

Miss Walker became senior nursing consul 
tant in 1949, a position she maintained until 
her retirement last November. 



"A gifted Ontario woman," and a great 
Canadian nurse, Edith MacPherson Dickson, 
died recently after a long and active life. 

The number of highlights in her profes 
sional career indicate the major role she 
played on the Canadian nursing scene. 

After graduating from the Toronto Gen 
eral Hospital School of Nursing, where she 
was noted "as being a leader" by Mary 
Agnes Snively, founder of the Canadian 
Nurses Association, Miss Dickson went to 
Weston as superintendent of nurses for the 
Toronto Tuberculosis Hospital. 

During the formative years of 1920-22 
Miss Dickson served a term as president of 
CNA. She was also the driving force that 
led to the passing of the Ontario Registration 
Act. 

One of the first three recipients of the 
Mary Agnes Snively Medal for outstanding 
accomplishments in nursing in Canada, Miss 
Dickson was also awarded an honorary life 
membership in CNA in 1958. 

Her many activities included membership 
on the committee to erect a national memo 
rial in the Hall of Fame, Parliament Build 
ings, Ottawa, in honor of nurses who lost 
their lives in the First World War. 




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THE CANADIAN NURSE 19 







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Even modern enema equipment is cumbersome and time- 
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dates 



February 9-10, 1967 

Meeting of Standing Committee on 
Nursing Education, CNA House, 
Ottawa. 

End of March 

Institutes for Instructors 

Ramada Inn, Vancouver, B.C. 

A two-day institute sponsored by the 

Registered Nurses Association of B.C. 

March 19 and 22, 1967 

Department of National Health and 
Welfare, National maternal and 
Child health conference. 
Talisman Motor Hotel, Ottawa. 
Inquiries: Dr. Jean Webb, Chief, 
Child and Maternal Health Division, 
Department of National Health and 
Welfare, Brooke Claxton Building, 
Ottawa 3, Ontario. 

April 28, 1967 

Nurses institute on respiratory 
disease, National Museum, Ottawa. 
; For information write The Canadian 
Tuberculosis Association, 343 
O Connor Street, Ottawa 4. 

May 4-6, 1967 

St. Boniface Hospital, School of 

Nursing, 25th Reunion of the 1 942 

graduating class. 

Would members of the 1942 

graduating class please write to Miss 

F.E. Taylor, R.N., 10123-122 Street, 

Edmonton. 

May 8-12, 1967 

National League for Nursing, Biennial 
Convention. Theme: "Nursing in the 
Health Revolution." 
New York Hilton Hotel, New York City. 

May 10-12, 1967 

Canadian Hospital Association, 
Montreal, P.O. 

May 15, 1967 

National Nursing Day. 

May 16-19, 1967 

Alberta Association of Registered 

Nurses Annual Meeting. 

Chateau Lacombe, Edmonton, Alberta. 

May 24-26, 1967 

International symposium on electrical 

activity of the heart. 

London, Ontario. 

For further information, write to 

Dr. G.W. Manning, Victoria Hospital, 

London, Ont. 

FEBRUARY 1967 



May 29-31, 1967 

Operating Room Nurses Fourth 
Ontario conference. 
The Inn on the Park, Toronto, Ontario. 
Sponsored by the Operating Room 
Nurses of Greater Toronto. 
Direct inquiries to: Mrs. Eleanor 
Conlin, R.N., 437 Glen Park Avenue, 
Apt. 309, Toronto 19, Ontario. 

May 31-June 2, 1967 

Registered Nurses Association of 
Nova Scotia Annual Meeting, Sydney, 
N.S. 

May 31-June 2, 1967 

Registered Nurses Association of 
British Columbia Annual Meeting 
Bayshore Inn, Vancouver, B.C. 

June 5-8, 1967 

Atlantic Provinces Hospital Association, 
Annual Meeting. 

June 12-15, 1967 

Canadian Dietetic Association 32nd 

Convention 

Chateau Laurier, Ottawa. 

June 18-21, 1967 

Ottawa Civic Hospital, Centennial 
Home Coming. 

Alumnae of former associates of the 
Ottawa Civic Hospital who are 
interested in the program should 
write to: Executive Director, Ottawa 
Civic Hospital. 

June 18-23, 1967 

Canadian Medical Association, 

1 00th annual meeting, Montreal, 

Quebec. 

Address enquiries to Dr. A.D. Kelly, 

Executive Secretary, ISO St. George 

St., Toronto 5, Ontario. 

June 24, 1967 

St. Joseph s Hospital School of 
Nursing, Toronto, Centennial Reunion. 
Any graduates who do not receive 
alumnae newsletters, please send 
name and address to: St. Joseph s 
Hospital School of Nursing Alumnae, 
30 The Queensway, Toronto 3, 
Ontario. 

July, 1967 

75th Anniversary, Nova Scotia 

Hospital School of Nursing, 

Dartmouth, N.S. 

All interested graduates please 

contact Mrs. G. Varheff, 

20 Ellenvale Ave., 

Dartmouth, N.S. 



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THE CANADIAN NURSE 21 



A nursing career with a difference. 



Excellent career opportunities exist 
for graduate nurses in the Canadian 
Forces Medical Service. Applica 
tions will also be accepted from 
nursing students in their final 
year of training. And enrolment 
will proceed upon registration. 

The duties of a Canadian Forces 
Nursing Sister are two-fold; that of 
a professional nurse and that of a 
commissioned officer. Her employ 



ment therefore 
the respon- 
leadership as 
of the medical 
It also carries 
portunities 




carries with it 
sibilities of 
well as those 
profession, 
with it op- 
to travel, to 
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serve in Canadian 

tablishments all across Canada 

and in Europe. 



The starting salary is $540.00 a 
month, and increases in pay are 
granted every three years. 30 days 
annual holiday, and free medical 
and dental care are added benefits. 
Nursing in the Canadian Forces 
Medical Service offers valuable and 
varied experience in different en 
vironments, opportunities for pro 
fessional advancement, the excite 
ment of travel at home and over 
seas, a respected position, and a 
unique way of life not usually 
available to a Registered Nurse. 

Further information and appli 
cations for enrolment may be ob 
tained from your nearest Canadian 
Forces Recruiting Centre, or by 
mailing the attached coupon. 



The Canadian Forces. 
Give it some thought. 



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Director of Recruiting, 
Canadian Forces Headquarters, 
Ottawa 4, Ontario 



Name- 



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22 THE CANADIAN NURSE 



FEBRUARY 1967 



in a capsule 



Drugs from the Depths ? 

The underwater life of Australia s Great 
Barrier Reef may be a potential source of 
new therapeutic agents, according to Dr. 
Robert Endean of the University of Queens 
land. 

Working with a six-man team, Dr. Endean 
has isolated from one variety of cone shell 
a toxin that produces muscular relaxation. 
This toxin affects only skeletal muscles, and 
does not appear to produce any of the side 
effects associated with curare type of drugs. 

Another variety of cone shell has yielded 
a toxin that causes sustained contraction 
of muscle. Dr. Endean reports, "I know 
of no other substance in the world which 
can achieve this effect, and it may prove 
to be valuable as a heart stimulant. We 
have already successfully tried it on the 
heart muscle of the toad." The Homer 
Newsletter. 

"Pure" Doctors 

A selection of nurses examination mis 
takes, compiled by Roger Brook, has been 
published by the Souvenir Press, London, 
under the title "And after that Nurse?" The 
following excerpts show just how important 
wording can be. . . 

A cross infection committee was set up 
in the hospital to deal with affection be 
tween nurses and patients. 

Phenobarbitone may be given to seduce 
the patient and put his mind at rest. 

Cross infection is always blamed on 
nurses, but the real bugbears in this respect 
are the doctors who think they are too 
;pure to carry such things as germs. 
Nursing Mirror, 122 : 599, Sept. 23, 1966. 

The Nose Knows 

One of the most disagreeable factors in 
working with geriatric patients, particularly 
those who are incontinent, is urinary odor 
which frequently permeates the entire en 
vironment where patients are housed. A 
report in a medical journal stating that 
cranberry juice was used to deodorize 
wards having incontinent patients, prompted 
Charles R. Du Gan and Paul. S. Carda- 
ciotto to conduct an experiment in two 
geriatric wards, one containing 110 male, 
the other 110 female patients. 

During the program the usual methods of 
deodorization were discontinued and odor 
levels were obtained chemically as well as 
noted subjectively by personnel. 

The doses of cranberry juice were gra 
dually increased from three ounces per pa 
tient per day to a maximum of six ounces 
daily. The chemical tests on the urine and 

FEBRUARY 1967 



air reflected little change in either male or 
female wards after the administration of 
cranberry juice was begun. 

The personnel, using their noses as guides, 
reported more significant impressions. After 
the first week of giving cranberry juice, 
personnel noted that the odors were less 
evident in the wards. As the dose was 
increased, the odors became markedly re 
duced. It was also reported by the ward 
personnel that the patients who had com 
plained of a burning sensation on urination 
no longer complained of discomfort. Those 
incontinent patients who had had a strong 
odor about them seemingly had less odor 
when receiving cranberry juice regularly. 
The urine odor on clothing and bed linen 
was reduced markedly. 

During the administration of the cran 
berry juice, no untoward reactions were 
noted in any of the patients. Excerpts 
from Journal of Psychiatric Nursing, Sept 
ember, 1966. 

Beautiful Eyes 

Communication between adults has be 
come a highly sophisticated art, with the 
result that true feelings are often lost be 
neath a protective covering of words. It is 
a lack of such sophistication that makes 
the speech of mentally retarded adults 
childlike in quality. What we mistake for 
stupidity in the conversation of retarded 
adults is often a frankness and direct sim 
plicity so often absent in our more technical 
manipulation with words. 

Jerome Nitzberg, M.S.W., in the Sept. 
issue of Canada s Mental Health, cites a 
few examples of the disarming --if not 
always rational formulations of the re 
tarded. One young man with a talent for 
leaving the floor dirty after mopping it, 
sincerely explained that "the floor is too 
big and the mop is too small." Another 32- 
year old childishly explained why he ne 
glected to bathe more often: "I ll only get 
dirty again!" A young woman, in explaining 
why she wept so frequently, commented, 
"My eyes are beautiful when they are full 
of tears." 

Employee Services Recognized 

The presentation of long service awards 
is well established in industry, but equally 
industrious hospital employees often go 
unrecognized. That is until recently, when 
the Brockville General Hospital in Brock- 
ville, Ontario, set a precedent by awarding 
31 long service awards to personnel em 
ployed there for more than 10 years. 



The director of nursing, Vera J. Preston, 
proved to have the longest service of all 
over 25 years. Miss Preston, who began 
employment with the hospital on March 1, 
1938, received the top award of a gold 
watch as well as a gold service pin for 
"faithful devotion to her duties." 

Miss Nora Towe, of the food service 
department, received a 20-year gold service 
pin, and Miss Gladys Edwards, supervisor 
of the central supply department, who is 
only a few months short of 15 years service, 
received a 10-year service pin. Other nurses 
with 10 years and more service were: Miss A. 
Foster, Mrs. S. Willows, and Miss Joan 
Freeman. 

All departments of the hospital were 
represented, including housekeeping, engi 
neering, administration, and food service. 

Burnt Cakes and Car Accidents 

Insurance companies take note! From the 
results of her "Experimental Study of Home 
Accident Behavior," Dr. Joan Guilford, 
director of the American Institutes of 
Research in Los Angeles, concludes that 
"one might speculate that a woman drives as 
she keeps house." The frequency of accidents 
in the kitchen appears to be related to the 
frequency of those on the highway and to 
vehicle code violations, a study of auto- 
accident and violation records of 178 women 
indicated. Further, the type of auto accident 
. personal injury or property damage - 
seems selectively related to those in the 
kitchen. 

Dr. Guilford, who conducted the experi 
ment using a mobile van with simulated 
home kitchen and one-way observation 
rooms, found that not only were home acci 
dents correlated with auto accidents and 
traffic violations, but also that other factors 
the number of a woman s children, her 
drinking habits, weight, personality traits 
and blood pressure were related in many 
cases to accidents or near accidents. 

What factors may "predict" kitchen (and 
possibly automobile) accidents? One of the 
best, most consistent indications at least 
in this study was the number of children 
each subject had. "It seems clear that those 
subjects with more children have the lower 
accident rates," said Dr. Guilford. 

Other results indicated that when com 
pared to teetotalers, women who drank al 
coholic beverages were less likely to have 
kitchen accidents. Emotionally unstable 
women tended to have more personal-injury 
accidents, but not property damage. Both 
thin and obese subjects had more accidents 
than did average-weight subjects. 

THE CANADIAN NURSE 23 




contents 

Introduction 

Body Fluid, Our Heritage from the Sea 

Cellular and Extracellular Fluid; Secretions and 

Excretions 

Units of Measure 

Gains and Losses of Water and Electrolytes 

Volume Changes in Extracellular Fluid 

Composition Changes of Major Extracellular 

Electrolytes 

Position Changes of Water and Electrolytes of 

Extracellular Fluid 

The Role of Nursing Observations in the Diagnosis 

of Body Fluid Disturbances 

The Elements of Nutrition 

The Nurse s Role in Preventing Imbalances of Water, 

Electrolytes, and Other Nutrients 

Help from the Lab 

Gauges for Dosage 

The Treatment of Body Fluid Disturbances 

Parenteral Fluid Administration Nursing 

Implications 

Fluid Balance in the Surgical Patient 

Fluid Balance in the Badly Burned Patient 

Fluid Balance in the Patient with Digestive Tract Disease 

Fluid Balance in the Patient with Urological Disease 

Fluid Balance in the Patient with Cardiac Disease 

Fluid Balance in the Patient with Endocrine Disease 

Fluid Balance in the Patient with Neurologic Disease 

Fluid Balance in the Patient with Respiratory Disease 

Water and Electrolyte Disturbances from Heat 

Exposure 

Fluid Balance Disturbances in Infants and Children 

Bibliography 

Index 




To help save lives! 

A new and vitally important book 
on the nurse s role in prevention 
of body fluid disturbances. 



NURSES HANDBOOK 
OF FLUID BALANCE 

Medical science recognizes that body fluid disturbances represent 
the common denominator of a host of illnesses; that every patient 
is a candidate for one or more of these disturbances; and that the 
life of a patient may depend upon early recognition, interpretation 
and intervention. Since the early recognition of fluid imbalance 
depends upon close observation of the patient, the nurse carries 
a heavy responsibility. She must be alert to adverse signs in the patient s 
progress and must understand their significance. 
Eminently qualified, the authors write with an insight into the 
medical problems and nursing needs of patients with fluid imbalance 
and provide the nurse student and graduate alike with a well- 
illustrated, comprehensive and illuminating book on body fluid 
disturbances. Emphasis throughout is on knowing what to look for 
how to look for it and what to do about it. - - The authors 
first present general information concerning body fluid disturbances 
- their nature, pathogenesis, clinical manifestations and diagnosis. 
They then deal with the important clinical areas. 

By Norma Milligan Metheny, R.N., M.S., Department of Nursing, 

St. Louis Junior College, St. Louis, Missouri; formerly Medical-Surgical 

Coordinator, Missouri Baptist Hospital School of Nursing, St. Louis. 

William D. Snively, Jr., M.D., Clinical Professor in the Department of 
Pediatrics, Medical College of Alabama; Vice President, Medical Affairs, 
Mead Johnson & Company; formerly Chairman, Fluid Balance Exhibit 
Committee, American Medical Association. 



275 PAGES 



90 ILLUSTRATIONS 



1967 



$7.50 



J. B. LIPPINCOTT COMPANY OF CANADA LTD., 6O Front Street West, Toronto 1. 

Please send me copy(ies) NURSES HANDBOOK OF FLUID BALANCE $7.50 

NAME [J Payment enclosed 

ADDRESS rj Charge 

CITY PROV. CN J47 



24 THE CANADIAN NURSE 



FEBRUARY 1967 



new products { 



Descriptions are based on information 
supplied by the manufacturer and are 
provided only as a service to readers. 



Pregslide 

(BELL-CRAIG) 

Description - - A simple, inexpensive, 
and highly accurate urine test for preg 
nancy. The Pregslide kit gives results in two 
minutes with an accuracy of 97%. Because 
of its high sensitivity, the new test can 
detect pregnancy earlier than any other 
slide test. 

Procedure - - To perform the test, two 
prepared reagents are mixed with a single 
drop of the patient s urine on a specially 
tinted blue slide. The mixture will assume 
a smooth and, finally, a granular pattern if 
the patient is pregnant. In a negative test, 
agglutination (clumping) will be visible 
within two minutes. 

For information on the new pregslide 
Jcit contact Bell-Craig Pharmaceuticals, 451 
Alliance Ave., Toronto 9, Ont. 

Showplace 

(BREWSTER) 

Description - This portable, table-top 
exhibition panel unit is offered in a variety 
of panel surfaces for use in hospital lob 
bies, for fund raising or general public 
relations displays, and in nursing schools 
for instructional exhibits. 

The 25 Ib. Showplace unit provides 24 
square feet of exhibit space in two 24" x 
36", two-sided panels encased in hard 
wood frames. The equipment comes com 
pletely assembled. 




The panel surfaces includes: V4" thick 
"doeskin" Homasote, V4" thick pegboard, 
W thick burlap-covered Homasote or Vi" 
thick burlap-covered pegboard. Frames are 
finished in walnut or driftwood. 

The Homasote panels will accept picture 
hoojcs, nails, staples, pins and tacks, while 
the pegboard versions take print clips, 
hooks and shelves supplied by the manu 
facturer. 

For further information, contact: The 
Brewster Corporation, Old Lyme, Conn. 
06371. 

FEBRUARY 1967 



Urecholine 

(MERCK, SHARP AND DOHME) 

Description A new dosage size (25 mg. 
tablet) for Urecholine chloride has been 
added to the existing 5 and 10 mg. tablet 
size and the 5 mg./cc. injection form. 

Urecholine chloride (bethanechol chlor 
ide) is a parasympathomimetic agent that 
increases the smooth muscle tone of the 
gastrointestinal and urinary tracts. 

Indications - Urecholine chloride is 
recommended in the treatment of certain 
cases of postoperative urinary retention 
and atony of the bladder, postpartum uri 
nary retention, postoperative abdominal 
distention, and incongenital megacolon 
when drug therapy is indicated. 

Dosage - - Dosage and route of admin 
istration must be individualized, depending 
on the type and severity of the condition 
to be treated. Mild and moderate disorders 
often respond to the tablet. Subcutaneous 
injection should be reserved for patients 
who do not respond to oral therapy. 

Oral: The usual adult dosage is 10 to 
30 mg. three or four times a day. Satis 
factory response often follows 10 to 15 mg. 
The minimum effective dose is determined 
by giving 5 or 10 mg. initially and repeat 
ing the same amount at hourly intervals 
to a maximum of 30 mg. until a satisfac 
tory response occurs. The effects of the 
drug sometimes appear within 30 minutes 
and usually within 60 to 90 minutes. They 
persists for about an hour. 

Subcutaneous: The usual dose is 1 cc. 
(5 mg.), although some patients respond 
satisfactorily to as little as 0.5 cc. (2.5 mg.). 
The minimum effective dose is determined 
by injecting 0.5 cc. (2.5 mg.) initially 
and repeating the same amount at 15 to 
30 minute intervals to a maximum of four 
doses until satisfactory response is obtained, 
unless disturbing side effects appear. The 
minimum effective dose may be repeated 
thereafter three or four times a day as 
required. 

Injection Urecholine chloride is for sub 
cutaneous use only. It should never be 
given intramuscularly or intravenously, 
since violent symptoms of cholinergic over- 
stimulation are likely to occur. Atropine 
is a specific antidote. A syringe containing 
a dose for adults of 0.6 mg. (1/100 grain) 
or more of atropine sulfate should always 
be available to treat symptoms of toxi- 
city. 

Contraindications Urecholine chloride 
is contraindicated in hyperthyroidism, preg 
nancy, peptic ulcer, latent or active bron 
chial asthma, pronounced bradycardia or 



hypotension, vasomotor instability, coron 
ary artery disease, epilepsy and parkin- 
sonism. 

Side Effects Subcutaneous doses of 
1 cc. or less may cause such mild side 
effects as abdominal discomfort, salivation, 
flushing of the skin or sweating. 

For further information or to receive 
the Urecholine file booklet, contact: Merck, 
Sharp and Dohme, P.O. Box 899, Mon 
treal 3, P.Q. 

Literature Available 

Patterns of Disease, a booklet published 
six times yearly by Parke, Davis and Comp 
any, features "special reports" which would 
be of interest to nurses. 

Examples of the reports featured during 
1966 are "Venereal Disease" (March- 
April), "Speech and Hearing Disorders" 
(May-June), "The Nation s Health Man 
power" (July-August), and "Gastrointes 
tinal Disorders" (September-October). 

Composed of numerous charts, graphs 
and illustrations, these reports offer a fund 
of interesting facts. 

Also published by Parke, Davis and 
Company, Ltd., "as a service to physicians," 
is their booklet Therapeutic Notes and 
its French counterpart Notes Therapeuti- 
ques. 

Containing more description and fewer 
charts and illustrations that the first book 
let, Therapeutic Notes features several 
articles in an attractive magazine format. 
Besides the regular "ten-second abstracts," 
articles on such topics as infectious mono- 
nucleosis, bites and stings, and eye dis 
orders in the aging patient have appeared 
in the past year. 

Nurses can have their names added to 
the mailing lists of either publication by 
writing, individually, and specifying which 
publication, to Parke, Davis and Company, 
Ltd., 5910 Cote de Liesse Rd., Montreal 9, 
P.Q. 

The proceedings of the International 
Symposium on Physical Activity and 
Cardiovascular Health, which was sponsor 
ed by the Ontario Heart Foundation 
together with the Ontario and Canadian 
Medical Associations, are now available at 
a cost of $3.00 each. 

This Symposium, held in October, 1966, 
included 31 speakers and 43 discussants 
at a gathering of 550 persons in the various 
fields of medicine and physical education. 

Orders for the proceedings should be sent 
to the Ontario Heart Foundation, 247 
Davenport Road, Toronto 5, Ontario. 

THE CANADIAN NURSE 25 



help wanted in Antigua, Burundi, 

Columbia, Ghana, India, Jamaica, Kenya, Madagascar, 

Peru, Rwanda, Sarawak, Tanzania, Tchad, Trinidad, Uganda, and Zambia. 



it s your world. 




These countries have a lot in common. Every one is 
no place for you if all you have to offer is lofty 
ideals. These are countries that need realists people 
who are ready to get down to work. And come down 
to earth. Literally. Don t kid yourself . . . signing up 
with this outfit will mean slugging it out through a 
tough, demanding job. That s the only way you ll fill 
the needs of these countries. And who knows, maybe 
you ll have a few of your own filled. What is CUSO? 
It s a national agency created to develop and pro 
mote overseas service opportunities for Canadians. 
It arranges for the placement of qualified men 
and women in countries that request their 
services. If you re sent to a country it s be 
cause they ve asked for you. Or someone 
like you. How does CUSO work? Abroad, it 
works through different international agencies 
who all assist in the placement of personnel. 
In Canada it works through local co-ordinating 
committees, located in most universities, but serv 




ing the whole community. What kind of people are 
needed? People who can adapt their skills and training 
to a far-from-perfect environment. Nurses who are 
able to cope with frustrating (and often primitive) 
working conditions. Nurses who can train and super 
vise other nurses. Nurses who can earn respect, 
and give it. Think about it. You ll know if you ve got 
what it takes. What is the selection procedure like? 
Tough. Because we don t believe in sending underdevel 
oped people to developing countries. Preliminary 
screening is carried out, where possible, by local 
committees. CUSO then nominates candidates 
to governments and agencies requesting per 
sonnel, who make the final selection. CUSO 
also makes arrangements for preparatory and 
orientation courses. How do you apply? Get 
more information and application forms from 
local CUSO representatives at any Canadian 
university , or from the Executive Secretary of CUSO, 
151 Slater Street, Ottawa. 



CUSO 

The Canadian Peace Corps 



26 THE CANADIAN NURSE 



FEBRUARY 1967 



A glimpse of nursing 
in the USSR 



This article is a thumbnail sketch of observations made by Dr. Mussallem during 
the Travelling Seminar on Nursing in the USSR last October. 



Helen K. Mussallem 




FEBRUARY 1967 



THE CANADIAN NURSE 27 



"Please fasten your seat belts. We 
will be landing at Moscow s Interna 
tional Airport in a few minutes." 

I looked out into the dark sky and 
the clouds suddenly vanished. "Those 
are the lights of Moscow," my com 
panion said, "and over there is the Red 
Square." 

I felt a strange tingle of excitement 
and wonderment. What is Russia really 
like? What are the people like the 
nurses the hospitals the schools 
of nursing? Is the Russian system of 
nursing so different from ours? Now, 
one of the dreams of my professional 
life was about to come true: I was 
going to find the answers to these 
questions and a thousand others during 
our month-long Travelling Seminar on 
Nursing in the USSR. 

The twain did meet 

The link between the Canadian nurs 
ing tradition and the Russian practice 
is tenuous, but, nevertheless, real. 
During the Crimean War, while Flo 
rence Nightingale was organizing nurs 
ing services for the British Army, Dr. 
Pirogov was organizing them for the 
Russian. Although each had the same 
basic objective, they never met to ex 
change ideas. 

Dr. Pirogov continued his work after 
the Crimean War, and organized all 
levels of health personnel in Russia. 
When the Soviet system of public health 
services was inaugurated simultaneous 
ly with the establishment of Soviet 
power in 1917, much of Pirogov s 
system was retained. 

After the Crimean War, Miss Night 
ingale returned to England where she 
promoted and developed high standards 
of nursing education and nursing prac 
tice. Her revolutionary ideas spread to 
virtually all English-speaking countries 

Dr. Mussallem, Executive Director of the 
Canadian Nurses Association, was a mem 
ber of the WHO Travelling Seminar on 
Nursing in the USSR. This article was not 
submitted to the USSR Ministry of Health 
for approval. 
28 THE CANADIAN NURSE 



in every part of the world. 

Now, 100 years later, 23 nurses who 
had been educated in modified patterns 
of the Nightingale system, were to meet 
with nurses and doctors of the Soviet 
Union who were products of the Piro 
gov system. 

Participants from many lands 

My Travelling Seminar colleagues 
were chief nursing officers in their own 
countries and literally came from the 
four corners of the world, or, more 
exactly, from the six World Health 
Organization Regions: Africa, Latin 
America, Eastern Mediterranean, Eu 
rope, South-East Asia, and Western 
Pacific. We were in the USSR to learn 
about the entire health program and 
especially about nurses and nursing. 
But we were to learn much more than 
that. We were to see cities, towns and 
villages in four Republics, meet the 
people, view the treasures of the past, 
participate in festivities, and return with 
a better understanding of this vast 
country of mystery, commitment, and 
contrast. 

Our colorful group convened at the 
Central Institute for Advanced Medical 
Studies in Moscow on October 6. 
Native costumes from Japan, the 
Sudan, India, Malaysia, Tanzania, and 
other countries displayed the splendor 
of the color spectrum. 

In the minds of all were many 
questions and some apprehension about 
what lay ahead. Certainly the warmth 
and friendliness of our colleagues in the 
Soviet Union left nothing to be desired. 
Even though the language barrier sep 
arated most of us, this was quickly 
overcome through the six interpreters 
who were always at our disposal. 

Free health services 

The Seminar was opened the first 
morning by the Deputy Minister of 
Health of the USSR who explained to 
us the basic socialist principles on 
which the health services are based. 
We soon realized that it was essential 
to have an understanding of these 
principles to appreciate how the meth 
odologies had evolved. 



The Deputy Minister spoke with 
great feeling of the importance of 
nurses. He said that he hoped this 
Seminar would be more than an ob 
servation of the health and nursing 
services in the Soviet Union and that 
the nurses from the countries repre 
sented would share their experience 
with their Soviet counterparts. This we 
did. 

The Minister told us that when 
Soviet power was established in 1917, 
the importance of health care was re 
cognized, and its availability to all citi 
zens, even in the most remote areas, 
was regarded as a vital function of the 
state. The constitution of the USSR 
states emphatically that each individual 
has a right to maintenance in sickness, 
disability and old age. All health ser 
vices are available free to all citizens 
(and to visitors, as we were soon to 
learn) in the Soviet Union. 

We were impressed with the great 
improvements made in health services 
since 1917. For example, at that time 
there were 46,000 middle medical 
workers the group to which nurses 
belong, 1.4 doctors per 10,000 popu 
lation, and 13.0 hospital beds. The 
average life span was 44 years. Today, 
there are 1,620,000 middle medical 
workers, 23.2 doctors per 10,000 po 
pulation, and 93.1 beds. The average 
life span is 66 years for men and 73 
for women. The measures used to ac 
complish these improvements were a 
revelation to us. 

Central control for health services 

Major planning for all health ser 
vices in the 15 republics is a function 
of the Central Ministry of Health in 
Moscow. Here, the regulations for the 
administration of all hospitals 
including nursing services are 
established. These regulations cover all 
sizes of hospitals from the large, com 
plex, oblast hospitals in the metropo 
litan areas to the very small feldsher* 
and midwife units on collective farms 
in remote parts of this immense 

*A feldsher is a category between physi 
cian and nurse; a "junior doctor." 

FEBRUARY 1967 




FEBRUARY 1967 



country. 

We toured all types of hospitals and 
health services in which nursing was 
involved, in four of the Republics: 
Russian, Ukranian, Georgian, and Ab 
khazian Autonomous Soviet Socialist 
Republic. In these republics we visited 
large cities, such as Moscow, Kiev, 
Tbilisi, and Vinnitsa, and small com 
munities, such as Sukhumi, and Tul- 
chinsk. We noted that the patterns 
of health service in every community 
generally followed the regulations spe 
cified by the Central Ministry in 
Moscow. 

Labor code protects worker 

The administration of nursing ser 
vices in the hospitals is unlike that of 
Canada. The main differences stem 
from the differences in ideologies and 
basic principles of management. In the 
USSR, legal regulations govern the em 
ployment of all workers, including 
those in medical and paramedical fields. 
The labor code gives protection to the 
worker and certain statutory powers to 
the trade unions. These are related to 
such matters as improvement of work 
ing conditions and scrutiny of the 
labor legislation. 

The legal labor regulations of all 
citizens are founded on principles of 
socialist management of labor as con 
tained in the Constitution. We were 
told by the head of the Labor Pro 
tection Department at the Central Com 
mittee for Medical Workers that the 
fundamentals of socialist labor legisla 
tion include: 

1. The universal obligation to work. 

2. A guaranteed right to work. 

3. Guaranteed remuneration of work 
depending on the quantity and qua 
lity of that work. 

4. A labor discipline and the ob 
servance of internal labor regula 
tions. 

5. Guaranteed safety and health con 
ditions of labor, legislation restric 
tions on working hours, and a 
guaranteed right to rest. 

6. Assistance in the improvement of 
qualifications and general educa 
tional standards of workers and the 
right to assistance and maintenance 

THE CANADIAN NURSE 29 



in case of disablement as determin 
ed by the law and at the expense 
of the State. 

Everyone works for the State and is 
paid by the State. There is no private 
enterprise, nor is there private practice 
by doctors, nurses or any other 
workers. Physicians, nurses, and other 
health workers are assigned to hospitals 
on a full-time basis. Public health 
functions are carried out by personnel 
of polyclinics, dispensaries, and felds- 
her units who visit and give health care 
in the home or anywhere in the com 
munity. 

All workers in the health field 
doctors, nurses, and even students 
belong to the same trade union. There 
is no voluntary professional associa 
tion like the CNA. Membership in the 
trade union provides generous benefits 
in relation to housing, vacation and 
recreation. Individual excellence and 
achievement is rewarded through addi 
tional money or through the provision 
of better living accommodation. 

Living accommodation for nurses is 
arranged by the State and is provided 
at a very minimum rate usually at 
five rubles (approximately $5.00 Cana 
dian funds) per month. It is difficult, 
however, to compare nurses salaries in 
the USSR with salaries paid to their 
counterparts in other countries, since 
the economic systems are basically 
different. When we acknowledge that 
so many services are provided full 
maintenance during retirement, holi 
days at very minimum expense, in 
expensive food and clothing we then 
recognize that the nurse s wages, from 
60 to 110 rubles a month, are quite 
sufficient to provide a comfortable 
living and enjoyment of the recreational 
and cultural offerings. For comparison, 
doctors are paid about 100 to 150 
rubles per month. 

No nursing hierarchy 

The chief physician in every hospital 
is also its chief administrative officer. 
The chief nurse is directly responsible 
to this doctor and, essentially, is his 
assistant. The senior nurse of a depart 
ment is directly responsible to the 

30 THE CANADIAN NURSE 



senior physician and works under his 
direct supervision. Together they super 
vise the nursing services provided in 
that department or unit. 

There is no nursing service depart 
ment and no direct line of authority 
between the chief nurse, the senior 
nurse, and the staff nurse. "We do not 
believe in a nursing hierarchy," I was 
told. Essentially, the doctor, nurse, and 
auxiliary personnel work together as a 
team, with the doctor in charge. This 
pattern also prevails in polyclinics and 
in other health units. 

Often we received the impression 
that duties were interchangable and 
that the person most available at the 
time performed the necessary task 
such as assisting a patient back to bed 
or holding a crying infant. It was diffi 
cult to identify the various categories 
of personnel since all wore the same 
uniform a white smock over street 
clothes and a white "surgeon s hat." 
Also, the majority of personnel in the 
health services are women, which adds 
to the identification problem. About 70 
to 75 percent of the doctors, the ma 
jority of the feldshers, and all of the 
nurses are women. 

Staffing of medical services 

Three categories of workers provide 
health care : the upper medical workers, 
which include physicians and stomoto- 
logists (dentists); the middle medical 
workers, which include the nurse, 
feldshers, and midwives; and the lower 
medical workers, who act as assistants 
to the middle medical worker. 

The staffing patterns of hospitals 
oblast, rayon, uchastock, polyclinics, 
etc. are determined by special re 
search and laid down in regulations 
by the Central Health Ministry in 
Moscow. However, each hospital is 
permitted to have more personnel in 
various categories, provided the request 
is justifiable. We were told that addi 
tional staff could be requested from the 
personnel office of the appropriate 
institutions at any time. The ratio of 
staff to patients varies according to the 
severity of illness and the age group. 
For example, the ratio is more favor 



able in units for acutely ill children 
than in units for convalescents. In a 
children s hospital the ratio may be 
one nurse to 6, 8, or 12 patients, and 
in a convalescent unit, one to 25. 
Doctors, too, are on the wards full 
time. 

Everyone works 

The Trade Union carefully regulates 
the hours of work for each citizen. The 
total work week is usually 41 hours 
with additional remuneration provided 
for overtime. 

Usually a hospital department has 
two shifts of nurses who work a six 
and one-half hour day; however they 
may work up to 12 hours. In some 
institutions, a nurse may work for 24 
hours and then be off duty for the 
next two days. 

Everyone in the USSR has both the 
obligation to work as well as the right 
to work. Unlike the situation in most 
countries represented at the Seminar, 
the Soviet nurses work for their normal 
span of years regardless of family 
status. They are allowed maternity 
leave of 56 days prior to and 56 days 
following the delivery of a child, and 
their children are cared for in creches 
or by relatives. 

Each health worker is required to 
work where she is assigned for the 
first three years after graduation. After 
this she may move to a hospital of her 
choice, but her freedom of movement 
is somewhat controlled by various 
methods. Following the three years of 
work in the assigned area, usually in 
a rural part of the country, nurses 
specialize in various fields such as diet 
therapy, physiotherapy, electrocardio- 
graphy, operating room assistant, phar 
macy assistant, etc. Indeed, it is cus 
tomary for her to continue with spe 
cialization, but she usually has the right 
to choose the specialty she will pursue. 
Thus, there is not a proliferation of 
professions or occupations in hospitals, 
but rather one profession with various 
degrees of specialization. 

"Bolshoi spasibo" 

Throughout our whole tour, both in 
FEBRUARY 1967 



the hospitals and ministries, the warm, 
friendly hospitality overwhelmed us. 
We quickly learned to say "spasibo" 
for thank you; however, because of the 
abundant hospitality, we asked our in 
terpreters for a word that expressed 
more than that, and soon progressed 
to "bolshoi spasibo." At every institu 
tion we were greeted in a room that 
had tables filled with cut-glass com 
potes of grapes and apples. Candies, 
booklets, and small broaches that de 
picted their famous men were distribut 
ed freely. Before we left, the nurses 
always came to our transport with a 
bouquet of flowers for each of us. 

The hospital visits usually began 
with greetings from the chief doctor 
and chief nurse. With the portable si 
multaneous translation equipment and 
six interpreters, the language barrier 
almost disappeared. Following intro 
ductions, we toured the departments 
and were able to ask questions and re 
ceive answers "on the spot." 

The size of departments and number 
of rooms depended on the nature of the 
hospital. In general, the patient settings 
were not unlike those in many Cana 
dian hospitals except, in the hospitals 
we toured, the patients beds were 
closer together. Usually five beds rather 
than three or four occupied a ward. 

The wards were very white: white 
beds, white linen, white walls. The doc 
tors and nurses all wore white hats and 
gowns over their street clothes. Some 
times we, too, donned the white gown 
and hat. The patients appeared to be 
well cared for and we sensed a warm 
relationship between them and the staff. 
In particular, we noted the very sensi 
tive care provided for sick children. In 
the children s hospital more color was 
used and there was a less regimented 
appearance. 

The operating rooms, polyclinics, 
and other health services had a physi 
cal appearance not unlike those in Ca 
nada, even though the categories of 
workers and their relationships were 
different. 

The nurses in each department of 
the hospitals worked under the direc 
tion of the physician and as his assis- 

FEBRUARY 1967 



tant. The doctor generally carried out 
all medical procedures, including blood 
transfusions, intravenous and intramus 
cular injections. 

A typical school of nursing 

What are the schools of nursing like 
in Russia? My visit to one of the 
middle medical schools gave me some 
insight. After a very warm greeting and 
a lecture by the director, a woman 
physician, we toured the school. 

The classrooms were bright and 
cheerful and the nursing students look 
ed young and lively. As we went from 
room to room we saw them practicing 
procedures procedures proce 
dures. In the first classroom they were 
practicing bandaging, and they all look 
ed so attractive even with the bandaged 
eyes, limbs and bodies. They had on 
clean white sm6cks over street clothes 
and white caps. I went over to speak 
to a small group without an interpreter. 
"Pajolsta," I said and they knew it 
meant "please." It was one of the few 
Russian words I knew and I was mere 
ly trying to comment. However, they 
unwrapped the bandages and put them 
on all over again. They were tickled 
when I tried to speak in Russian from 
my Guide Book. The interpreter came 
to my rescue, but I refused. "Bolshoi 
spasibo." Nurses do not need interpre 
ters in these situations. 

But there were more than nurses 
being prepared in this middle medical 
school. Feldshers, midwives, children s 
nurses, laboratory technicians, and 
other health personnel also attend this 
school to receive their training. 

The education of these workers, as 
for all workers, is free. The Ministry of 
Public Health in the USSR has a De 
partment of Medical Education that 
deals with all matters pertaining to 
every level of health worker education. 
The Minister is responsible for plan 
ning and approving the curriculum, 
which is uniform for all 630 schools in 
the 15 constituent republics. Each of 
the republics has its own Minister of 
Health who is responsible for supervi 
sion and guidance at the local level. 



However, the Central Ministry in Mos 
cow retains the function of inspection 
of the educational program as well as 
revision of the curriculum. 

There are more than 330,000 
students in the 630 middle medical 
schools, with the largest percentage 
being prepared as nurses. The length of 
the educational program for nurses de 
pends on the student s educational 
background. For example, if the stu 
dent has 8 years of schooling (incom 
plete secondary education), the length 
of the course is 2 years and 10 months; 
if she has 10 years of schooling (com 
plete secondary education), the course 
is 1 year and 10 months. 

Courses taught by physicians 

Physicians administer the middle 
medical schools and teach all the nurs 
ing subjects. Although no nurses are on 
the staff of the middle medical schools, 
they sometimes supervise students in 
the clinical field. General education 
subjects, offered to those with incom 
plete secondary education, are taught 
by general education personnel. 

One middle medical school that we 
visited prepares 1,200 students, of 
whom 780 are nurses. This ratio is 
fairly common for all middle medical 
schools throughout the Soviet Union. 

The teachers are physicians, but do 
not have special advanced preparation 
in pedagogy. Instead, committees on 
methods of teaching are formed to im 
prove the method and quality of the 
educational program in the schools. 
The teachers at the middle medical 
schools are usually on the medical staff 
of a nearby hospital where students 
obtain their clinical experience. They 
keep current on new medical advances 
by attending the Institute for Advanced 
Medical Studies where special courses 
are available. 

Recruitment not a problem 

At the present time, recruitment of 
students into nursing is not a problem. 
We were told that to expand the USSR 
health programs to the desired level, 
a larger number of nurses and other 
medical personnel is required. Last 

THE CANADIAN NURSE 31 




32 THE CANADIAN NURSE 



FEBRUARY 1967 



year, 107,000 students were admitted 
and 120,000 admissions are planned 
for this year. The teachers from middle 
medical schools visit secondary schools 
to talk about nursing as a career, and 
prospective students are invited to 
"open door days" at middle medical 
schools. When students visit the middle 
medical schools, the teachers explain 
the program and the opportunities 
available. Married students with or 
without children are permitted to enter 
the school and those who become preg 
nant are given academic leave. There 
are no student organizations, but stu 
dents have the option of becoming 
members of a trade union. This mem 
bership offers many advantages and 
almost 95 percent of the students join 
during their first year. 

Curriculum set by educators 

Unlike Canada, where the control 
of educational programs is centered in 
service agencies, the program of in 
struction in the USSR is prepared by 
an educational board of the Ministry of 
Public Health. Members of this board 
are experienced and highly skilled spe 
cialists. They meet periodically to re 
vise the common curriculum and the 
academic program for the middle med 
ical schools throughout the consti 
tuent republics. This board also out 
lines the ways in which the curriculum 
should be implemented, prescribes the 
textbooks to be used, and selects the 
authors to write the textbooks. 

The following pattern is used for 
all schools of nursing throughout the 
country. Each year is divided into two 
semesters. The first semester begins 
September 1 and lasts until January 
11; the second begins January 26 and 
lasts until July 5. All students have 
winter vacation from January 12 to 25, 
and summer vacation from July 6 to 
August 31. The students have a 35- 
hour week and a 6-hour day. This time 
may be spent on theory, practice or 
visits, depending on the level of the 
student in the educational program. 

The curriculum is divided into three 
cycles: cycle one is devoted entirely 
to general education; cycle two, to 

FEBRUARY 1967 



general medical subjects, as well as to 
anatomy, physiology, pharmacology 
and biology; and cycle three, to the 
special or clinical subjects, which in 
clude general care of patients, surgical 
diseases, obstetrics and gynecology, 
children s diseases, eye diseases, etc. 
The total planned hours of the curricu 
lum are 3,774, of which 2,516 are 
devoted to classwork and 1,228 to 
practical experience. 

The objective of the course for the 
preparation of nurses is "to train future 
nurses in the tending of patients and 
in medical skills." A review of the 
curriculum and observations made dur 
ing visits at middle medical schools 
revealed that the educational program 
is disease and procedure-centered, with 
emphasis placed on medical equipment. 
Diseases and health teaching are em 
phasized. Only a very small portion of 
the outline stresses the practice of 
nursing as an art and a skill. 

At the completion of the basic edu 
cational program, students write State 
examinations. Successful candidates re 
ceive a diploma of certification and 
are then assigned to a place of em 
ployment for three years. The top 5 
percent in any graduating class are en 
couraged to proceed to the higher med 
ical institutes to become doctors 
and the majority do. The remainder 
of the students who complete the three- 
year assignment may, until they are 30 
years of age, apply to the higher medi 
cal institutes to become doctors. 

Often we were told during the Tra 
velling Seminar that the goal of most 
middle medical workers, including 
nurses, is to become a physician, be 
cause "nurses conduct medical treat 
ments and apply medical equipment 
only in accordance with prescriptions 
and instructions of the physician in 
charge of the patient." 

Unlike the Canadian system, all stu 
dents attending middle medical schools 
live at home or in special apartments. 
The only exception to this is when the 
middle medical schools are located in 
the far north or where the homes of 
the students are a long distance from 
the school. 



A window in the iron curtain 

Although the program was very full 
with little time for relaxation, we man 
aged to squeeze in a swim in the Black 
Sea. The same night we packed for the 
twelfth time and returned to Moscow 
to complete our assignment. On the 
next night, our last in Moscow, the 
Ministry planned a dinner party for us. 
After the party, a companion and I 
walked up Gorky Street to the Red 
Square. I shall never forget the beauty 
of the moment when we looked through 
the falling snow across the Square. 
There were the beautiful cathedrals 
with their gold bubble domes accen 
tuated by the soft flood lights. I looked 
over to Gums Department Store where 
we had struggled in queues to make 
small purchases, then back to Lenin s 
tomb with the young soldiers standing 
stiffly on guard. Then, into my view 
came the gilded crescent and the five 
pointed red stars of the Kremlin, muted 
now by the falling snow. I could feel 
the past and the future there, but main 
ly the throbbing of the present. 

We turned and trudged back to our 
hotel. We hardly spoke. I was thinking 
of all we had done and seen in the 
past month, the nurses and doctors we 
had met, and how committed they were 
and how far they had come in so rela 
tively short a time. I realized that they 
were very much like all of us going 
out to work each day, coming home 
each night, and living their lives much 
as we do. 

Those of us in the first Travelling 
Seminar on Nursing in the USSR re 
turned to our native lands with many 
different impressions. We all agreed, 
however, that it had been a rewarding 
and exciting professional and personal 
experience. For us there are now win 
dows in the Iron Curtain. D 



THE CANADIAN NURSE 33 






Estrogen replacement therapy 
at menopause 



The average woman outlives her ovaries by 25 years. Estrogen from the corner 
drug store will correct this deficiency more naturally than 
tranquilizers and psychotherapy. 



Donald C. McEwen, M.D., F.R.C.S. (C), F.R.C.O.G., F.A.C.O.C. 



John Fitzgerald Kennedy, in his in 
augural address, challenged the 1960 s. 
He called on a new generation to find 
better solutions for old problems in a 
rapidly changing world. In medicine, 
a steroid revolution became one of 
the fascinating developments of this 
decade as two new freedoms, closely 
allied, reached fulfillment for many 
women: freedom from undesired preg 
nancy and freedom from premature 
old age. 

The impact of oral contraception 
on our generation needs little com 
ment. Ten million women throughout 
the world now use these estrogcn-pro- 
gestogen combinations for ovulation 
control and/or therapeutic purposes. 
Their safety and effectiveness have 
been repeatedly demonstrated by in 
numerable government agencies and 
concerned medical investigators. Minor 
problems, experienced by a small per 
centage of patients, capture dramatic 
newspaper and magazine discussion; 
for the "pill" causes symptoms similar 
to those of pregnancy, and with about 
the same frequency. Variations in the 
chemical structure and dosage of the 
constituent steroids will evolve; but 
oral contraceptives are here to stay, 
and doctors and patients, politicians 
and sociologists must now adjust to 
their astonishing role in modern so 
ciety. 

Most oral contraceptives inhibit 
normal pituitary ovarian function, so 
that these medications substitute for 
circulating steroids usually obtained 

34 THE CANADIAN NURSE 



from normal ovarian function. It is 
not widely appreciated that in pre 
scribing these agents, a doctor creates 
ovarian deficiency and, paradoxically, 
treats it at the same time; for with 
treatment, ovarian function becomes 
one of suspended animation. 

Some doctors, willing to prescribe 
these powerful drugs to young women 
with normal ovaries, remain reluctant 
to offer similar hormones to women 
suffering from true ovarian deficiency, 
a result of normal aging, congenital 
insufficiency, disease, surgery, or ra 
diotherapy. Little attention was paid 
to the menopause in medical school. 
Most doctors were taught that the 
menopause was a natural phenomenon, 
hormone treatment potentially danger 
ous and one to be condemned from 
a long-term point of view. 

The concept of ovarian deficiency 
as a medical entity is, however, gain 
ing recognition. If it is a valid clinical 
condition, one in every three women 
alive is a victim to a greater or lesser 
degree. Ovarian senescence may be 
rapid or gradual; but the result is the 
same. Estrogen blood levels decline, 
ovulation does not occur, and pro 
gesterone is not elaborated. The meno 
pause, or failure of menstruation, oc 
curs when these hormones are insuf 
ficient to ripen endometrial tissue. The 
Dr. McEwen, a graduate of the University climacteric encompasses a wider span 




of Manitoba, is an Obstetrician and Gyne 
cologist in Calgary, Alberta. He is on the 



from the time ovarian function falters 
until that occasion when total failure 



staff of the Calgary General, Grace, Rocky- occurs, usually about age 60. Ovarian 



view, and the Holy Cross Hospitals. 



dysfunction is a frequent occurrence 
FEBRUARY 1967 



after the age of 35, so many women 
will suffer ovarian deficiency or im 
balance for half their lifetime. 

Symptoms of menopause 

Symptoms suggesting an impending 
menopause are well known. The hot 
flush, usually the first symptom, is a 
sudden sensation of heat in the upper 
part of the body often associated with 
a patchy redness of the skin. Perspira 
tion and a feeling of chilliness may 
follow. Hot flushes seem to be more 
common with increased heat produc 
tion (stress, exercise, a hot room) or 
when heat loss is impaired (sultry 
weather, heavy bedclothes). Sleep is 
frequently disturbed and insomnia be 
comes a common complaint. 

Pituitary overaction may cause the 
hot flush as gonadotropin levels rise 
to stimulate estrogen production from 
aging, unresponsive ovaries. It may be 
due to fluctuating levels of estrogen. 
Excessive production of other pituitary 
tropic hormones results in an increas 
ed stimulation of adrenal, thyroid and 
pancreatic glands, resulting in further 
systemic disturbance. 

Fatigue, depression, and emotional 
instability may be unusually trouble 
some at this time. Such symptoms may 
be sensitive barometers of estrogen 
deficiency, or may be a reflection of 
pituitary hypothalamic turmoil, or be 
simply manifestations of environmen 
tal emotional influence (husband, fami 
ly or social upheaval). 

The signs and long-term effects of 
estrogen deficiency are much more sig 
nificant. The major physical hazards 
are degeneration and atrophy of uro- 
genital tract and breasts, blood vessels 
and bones; but the whole body is af 
fected by a lack of estrogen. Aging 
may be accelerated and joie de vivre 
disturbed, modified from patient to 
patient by variations in the degree of 
ovarian failure, individual sensitivity 
to estrogen deprivation, the patient s 
emotional strength, called motivation, 
her ability to handle stress, and the 
infinite vicissitudes of life. 

Atherosclerosis 

Until the menopause, women are 
FEBRUARY 1967 



relatively immune to coronary artery 
disease, but thereafter become more 
susceptible. Many observations have 
been made on the effects of castration 
on atherosclerosis. Castrated young 
women have rates of arterial disease 
similar to men of the same age. Re 
moval of ovaries at hysterectomy 
brings about a fourfold increase in the 
degree of coronary artery degeneration 
when compared to women whose ova 
ries are left. Replacement therapy with 
estrogen lessens this risk in women. 
In controlled studies of men who had 
coronary infarction or strokes, the use 
of natural estrogens produced signifi 
cantly longer survival and reduced the 
occurrence of secondary occlusive epi 
sodes. Long-term studies exploring 
these possibilities continue to excite 
medical investigators. 

At present, the lesson is quite clear. 
Normal ovaries should be retained at 
the time of hysterectomy and replace 
ment ovarian therapy is strongly indi 
cated for those patients who show 
evidence of hypertension or cardio 
vascular degeneration. 

Osteoporosis 

Postmenopausal osteoporosis of va 
rying degrees occurs in practically all 
women. The degree of mineral loss 
is directly related to the severity of 
ovarian failure and the elapsed time 
of estrogen depletion from all body 
sources. This is an insidious, overlook 
ed, and sometimes crippling disease. It 
may manifest itself clinically by low 
back pain from even minor trauma, 
shortening of stature, or dorsal kypho- 
sis (dowager s hump). Loss of density 
of bones by roentgenograms is a late 
sign. Elderly women fill our orthopedic 
wards with fractured hips, and many 
more who pass through the later stages 
of life suffer much distress from back 
and pelvic degeneration. Men do not 
suffer this affliction with any signifi 
cant frequency. 

The cause of osteoporosis remains 
debatable; but the consensus of opinion 
suggests it is due to increased bone 
resorption resulting from long con 
tinued negative calcium balance. 

Estrogens taken orally constitute 



the most effective and universally ac 
cepted treatment of osteoporosis, asso 
ciated with physiotherapy to restore 
maximum physical activity, and dietary 
regimens to supply sufficient minerals, 
and to keep patients in positive nitro 
gen balance. 

Genital atrophy 

It is estrogen that brings about the 
metamorphosis of a girl to a woman, 
stimulating breasts and genital tract 
and the whole body to maturity. It is 
the withdrawal of estrogen at the time 
of ovarian failure that reverses this 
process. Resorption of fat and loss of 
elastic tissue make breasts and external 
genitalia smaller and less full. The 
vulva becomes thin, irritable, and often 
itchy. The vagina and uterus become 
small and atrophic, supporting struct 
ures weaken, and genital prolapse is 
a frequent consequence. Urinary tract 
tissues share this estrogen dependency, 
and urinary dysfunction manifests by 
urgency, frequency, and urinary infec 
tions. Stress incontinence also may be 
part of a common and stubborn defi 
ciency syndrome. 

There is, therefore, considerable 
evidence that estrogen is protective to 
the mature woman, her cardiovascular 
system, bones, genital tract, joints, 
skin, and possibly every tissue in her 
body. Estrogen offers protection against 
psychological involution, apathy and 
negativism. The logical conclusion 
must be that adequate estrogen levels 
should, if possible, be maintained in 
women; that estrogen throughout a 
whole lifetime offers hope for positive 
health. 

Clinical study of ovarian deficiency 

For the past three years this con 
cept has been explored in some depth. 
By September 1966, 777 women with 
symptoms and signs of ovarian defi 
ciency of varying degrees were consi 
dered for supplemental or replacement 
estrogen therapy. Thousands of pa 
tients appeared in other doctors of 
fices as the potentialities of this therapy 
became known throughout the female 
population .These neglected women in 
dicated in the only way possible their 

THE CANADIAN NURSE 35 






personal concern and disenchantment 
for traditional treatment of the meno 
pause. 

A variety of treatment schedules 
to manage different clinical situations 
and to individualize patient needs is 
essential. These can be broken down 
into two simple types: treatment for 
the patient whose uterus has been re 
moved, and treatment for the patient 
whose uterus is intact. 

1. The patient whose uterus has 
been removed: These patients simply 
require sufficient daily estrogen to 
achieve maximum well-being and re 
store vaginal maturation indices to 
normal. A progestogen alone or com 
bined with added estrogen may be 
added for five days a month for ba 
lance; but this is not essential, for en- 
dometrial shedding is not required. The 
metabolic action and biological need 
of progesterone-like steroids remain 
obscure and ill-defined at the present 
time. 

Natural estrogens (conjugated estro 
gens, equine), marketed as Premarin, 
are preferred as the selected estrogen, 
being well-tolerated, effective, and 
uniquely beneficial in the treatment 
and prevention of atherosclerosis. 

2. The patient whose uterus is in 
tact: Most patients who have not had 
hysterectomy fall into four groups: 
age 35-50 (perimenopausal); age 50-60 
(menopausal); age 60-70; and age 70 
upward. 

Age 35-50 (perimenopausal): 

If ovulation control is desired, one 
of the combined or sequential estrogen- 
progestogen packets will fulfill treat 
ment purposes. Individualization is 
essential. The combined tabulation is 
indicated where menorrhagia has been 
a problem to reduce both the duration 
and quantity of bleeding. The sequen 
tial package is preferred where there 
has been gross disturbance of the 
menstrual cycle, particularly if bleed 
ing has been scant or painful. 

If ovulation control is not impor 
tant, natural estrogens (conjugated es 
trogens, equine) are useful and well- 

36 THE CANADIAN NURSE 



tolerated, and are prescribed from 
Day 1 to Day 21 of each cycle. One 
of the combined tabulations completes 
therapy from Day 22 to Day 26 to in 
duce medical curettage on Day 28. 
This cycle can be easily modified for 
convenience by shortening or prolong 
ing the estrogen phase. 

Age 50-60 (menopausal): 

The patient with gross ovarian de 
ficiency, as indicated by failure of 
menstruation, hot flushes or other 
symptoms and signs of the menopause, 
requires sufficient daily estrogen to 
satisfy her needs as determined by 
relief of symptoms and, helpfully, but 
less important, by the vaginal cyto- 
gram. Once this has been accomplish 
ed with the use of conjugated estro 
gens, (equine 0.625 mg. to 2.50 mg. 
daily), medical curettage is induced 
monthly with one of the combined es 
trogens and progestogens* in doses of 
0.5 mg. to 2 mg. of the progestogen 
for 5 to 10 days, in addition to the 
basic daily therapy with natural estro 
gens. The dosage and duration of this 
medical curettage regimen is indivi 
dualized after a few months according 
to the patient s behavior, the length 
and amount of menstrual flow, well- 
being, etc. 

Patients are allowed to decide the 
day of their menstrual flow by simple 
instructions; menses will occur two to 
three days following cessation of the 
medical curettage tablets. The menstru 
al flow should be scant, short, and 
without significant distress. There 
however if intermenstrual bleeding 
after the first two months of therapy; 
however if inter-menstrual bleeding 
occurs, diagnostic curettage is indi 
cated particularly if the bleeding does 
not respond to increased estrogen dos 
age. 



* Mestranol 0.1 mg. and ethynodiol diace- 
tate, .5 mg., 1 mg. (Ovulen), and 2 mg. (Me- 
trulen) were used in 55 percent of patients 
in this series, and were supplied by G.D. 
Searle and Company of Canada. 



Age 60-70: 

After the age of 60, the production of 
endogenous male hormone subsides to 
low levels. If continued menstruation 
is objectionable, the regimen may now 
be changed to one of a combined es 
trogen and androgen tablet for cycles 
of 25 days a month. The patient s well- 
being, a positive nitrogen balance, and 
adequate vaginal cornification indices 
are maintained. Menstrual function 
comes to an end, although in some 
patients slight withdrawal bleeding may 
occur when therapy is interrupted. 

Age 70 upward: 

Small amounts of estrogen, andro 
gen and geriatric vitamins given in 
combined tabulation for 25 days a 
month have been found most useful 
to maintain vigorous old age, with 
local estrogens given vaginally for uro- 
genital integrity. 

Such regimens allow easy individual- 
ization of each patient. The objective 
of this program is to extend middle 
age for women by 10 years, and, there 
after, to supply supportive anabolic 
steroids into old age. Sufficient ex 
perience has now been obtained to in 
dicate that this can be accomplished 
with few treatment problems. Such 
therapy appears safe, inexpensive and 
rewarding in its physical and emotional 
benefits. The basic concept of treat 
ment is similar to the use of thyroid in 
myxedema, or insulin in diabetes mel- 
litus. 

Discussion 

If there is a need for lifelong estro 
gen, and if treatment is easy, what then 
are the usual arguments against such 
therapy? 

Estrogen-Cancer Relationship 

No convincing proof that estrogen 
has caused cancer in a human being 
has ever been established, in spite of 
a widespread feeling among some doc 
tors and some laity that the opposite is 
true. Cancer of the breast is more 
treacherous in pregnancy when estro 
gen excretion levels are extremely high; 
but this association is rare, having an 
incidence of about three breast cancers 

FEBRUARY 1967 



in 10,000 pregnancies. In endometrial 
cancer, there may be evidence of a 
long-standing estrogen influence, and 
this lesion occurs with increased fre 
quency in association with estrogen- 
producing tumors of the ovary, and in 
ovarian polycystic disease (Stein-Levin- 
thal syndrome). This association does 
not indicate any definite carcinogenic 
relationship, but likely reflects an ab 
sence of progestational medical cu- 
rettage, for cyclic menstruation is na 
ture s method of endometrial deter- 
gence. 

The rarity of cancer in women with 
normal ovarian function, the insigni 
ficant number of reported cases of 
breast or genital cancer in women 
taking birth control pills or other es 
trogen therapy, the absence of experi 
mental evidence that estrogen incites 
cancer, suggest there is little signifi 
cant estrogen-cancer relationship. 

Continuing Menstruation 

Menstrual function is not a pleasant 
phenomenon. A waste of time, messy, 
expensive, often uncomfortable, it is 
understandable that, for most women, 
the menopause offers welcome relief 
after about 400 monthly cycles, less 
the normal interruptions of pregnancy 
and lactation. 

But menstruation is an excellent 
monitor of ovarian and uterine func 
tion. Normal cyclic menstruation is a 
reassuring indication that physiological 
replacement ovarian therapy has been 
achieved. Women with ovarian de 
ficiency obtain maximum benefit if 
normal estrogen-progestogen levels of 
these hormones are created. A 
natural consequence will be menstrua 
tion. This is accepted by most patients 
in the 50 to 60 age group when its 
significance is discussed. These women 
consider menstruation a small price 
to pay for relief from menopausal 
symptoms, with the additional pos 
sibility of delayed aging of many vital 
organs and functions. 

Expense 

Replacement ovarian therapy costs 
between $15.00 and $50.00 per year, 
depending on the steroids selected and 

FEBRUARY 1967 



the desired replacement. Cigarets cost 
$150.00 a year; weekly hairdressing 
averages $200.00. This therapy must 
be considered inexpensive in any com 
parative study with clothes, cosmetics, 
alcohol or travel. 

Tampering with Nature 

This argument is the most superficial 
of all. Doctors, nurses, and the healing 
professions generally, wage a constant 
battle against nature s hazards. Anes 
thesia, modern surgery, antibiotics, 
blood transfusions, immunization, and 
pasteurization are examples of tamper 
ing with nature. And who would argue 
against their use? The person who be 
lieves that the menopause is a natural 
process defies nature every day by 
wearing clothes, eating foods or driving 
cars. Modern man flies against gravity 
and sends rockets to the moon. 

Nature has fallen behind medical 
progress, for the average woman will 
outlive her ovaries by 25 years. 
Estrogen from the corner drugstore 
will correct this deficiency more natur 
ally than tranquilizers and psycho 
therapy. 

What About Men? 

The argument that there are already 
too many elderly women and widows 
in the world, and the question "What is 
to be done for men?" is much more 
pertinent. Doctors interested in this 
concept for women are concerned with 
adding abundance rather than years to 
life. In men, male hormones, hyper 
tension, and atherosclerosis are bad 
associates, particularly when linked 
with the stress of the market place, 
unfulfilled ambition, cigaret smoking, 
obesity, and lack of physical fitness. 
These influences become complicated 
when assessed individually. Generally, 
to the extent that a menopausal wife 
can, with hormones, enjoy a fulfilled 
middle age, men can approach the 50 s 
certain that their wives will remain 
feminine emotionally, physically, 
and sexually down the road of life. 
It is hoped that this may be a strong 
influence on longevity as the other 
problems of male aging are studied and 
conquered. 



Summary 

The case for lifelong estrogen for 
women has been discussed. Experience 
in studying 777 women who have been 
assessed for this treatment suggests 
overwhelming acceptance of the basic 
concept. There is need for wide appli 
cation of its potential benefits to the 
millions of women suffering actively 
or passively from ovarian deficiency, 
particularly after the menopause. D 



THE CANADIAN NURSE 37 






Estrogen and the 
menopause 



Estrogens are by no means a panacea for all the problems of aging in women. 
They must be used knowledgeably and not simply as a tonic. 



Jean Blanchet, B.A., M.D., F.R.C.S. (C) 



A wealth of articles recommending 
the use of estrogen both before and 
after the menopause have appeared in 
the literature of the medical and para 
medical professions for several years 
now. Some authors have even sug 
gested cyclic administration of an es 
trogen-progesterone combination de 
signed to restore a menstrual pattern 
in the menopausal woman. Whether 
or not the woman herself is desirous 
of such a result would appear to be 
a legitimate question. As one outcome 
of this literary deluge, many persons 
have wondered about and questioned 
the value of estrogens as a sort of 
legendary Fountain of Youth able to 
rejuvenate anyone who bathes in its 
waters. 

Two distinct philosophies can be 
gleaned from the mass of literary opin 
ion on the subject of the menopause 
in general. On the one side we have 
those who consider the menopause as 
an illness and consequently believe that 
the climacteric woman should receive 
compensatory hormonal therapy in 
definitely, however minor her symp 
toms. On the other side are those who 
view the menopause as a period of 
physiological adjustment or adaptation 
to a new phase of life and who reserve 
hormonal therapy for the woman who 
exhibits estrogen deficiency. This phil 
osophy represents the thinking of the 
majority of medical writers. 

In this article the indications for 
and methods of estrogen administra- 

38 THE CANADIAN NURSE 




Dr. Blanchet is on the obstetrical and gyne 
cological service of The Montreal General 
Hospital. 

tion will be discussed and, by out 
lining the various precautions and 
contraindications involved, it will be 
shown why hormonal therapy should 
not be used routinely or indefinitely 
in all women of menopausal age. 

Artificial menopause 

A distinction must first be drawn 
between natural and induced meno 
pause. Young women who have un 
dergone bilateral oophorectomies or 
radiation castration necessarily re 
quire special consideration. Compen 
satory estrogen therapy is definitely in 
dicated to offset the sudden and almost 
total suppression of estrogen forma 



tion by the body, and subsequent 
premature aging. 

Natural menopause 

The menopausal phenomenon oc 
curring as an outcome of natural ova 
rian failure shows considerable varia 
tion from one woman to another. Vagi 
nal smears taken several years after on 
set show only minor estrogen deficiency 
in most women examined. Medical 
writers are in general agreement that 
only 15 to 25 percent of menopausal 
patients have symptoms that warrant 
hormonal therapy. In actual fact, only 
the hot flushes experienced by the 
climacteric woman are directly due to 
hormonal deficiency. Other symptoms 
such as depression, anxiety, and in 
somnia are temporary manifestations 
of psychological problems. The me 
nopause is essentially a physiological 
process which is only occasionally as 
sociated with a hormonal deficiency. 
Compensatory therapy is indicated 
only for those women who show mark 
ed symptoms of this deficiency. 

Diagnosis 

The estrogen-deficient menopausal 
patient is easily recognized by a his 
tory of hot flushes, night sweats, leu- 
corrhea, bloody vaginal discharge, as 
the result of a vaginitis or atrophic 
cervicitis. Cytology results confirm the 
suspicion with the finding of a low 
percentage of cornified cells. The 
atrophic vaginal mucosa shows an 

FEBRUARY 1967 



abundance of immature and parabasal 
cells. Cytology has become part of 
routine examination. It is easily per 
formed and can be carried out as 
readily in the doctor s office as in 
the laboratory. 

Clinical signs 

Laboratory and clinical findings de 
monstrate the result of hypoestrinism. 
There is atrophy of the secondary 
sexual characteristics and of the sexual 
organs, with senile vaginitis. Excessive 
activity of the anterior hypophysis is 
manifested by hot flushes and night 
sweats. Metabolic changes occur with 
associated hypercholesterolemia, athe 
rosclerosis and hypertension. Osteo 
porosis may develop as well. 

Hormonal therapy 

Women who experience acute, in 
tractable vasomotor disorders that do 
not respond to symptomatic therapy 
are candidates for estrogen therapy 
until their symptoms disappear. Osteo 
porosis and atherosclerosis are the two 
conditions to be feared in those pa 
tients suffering from acute estrogen 
deficiency either at the time of the 
menopause or later. Osteoporosis of 
the spinal column may appear as late 
as five years after the onset of the 
menopause. Backache is the usual 
complaint characterizing this condition 
although spontaneous fractures may 
occur as the process continues. Radio 
logical examination is necessary to 
confirm the presence of osteoporosis. 
Hormonal therapy can slow down and 
even prevent further degenerative 
changes while the patient s energy, 
strength and general sense of well- 
being are augmented. 

Atherosclerosis, with its attendant 
threat of myocardial infarction and 
hypertension, most commonly affects 
males rather than young women. How 
ever, the incidence tends to become 
the same for both sexes after the age 
of 60 if the woman shows signs and 
symptoms of hypoestrinism. About 20 
to 25 percent of patients require com 
pensatory hormonal therapy. Cyclical 
administration of estrogens has a 
preventive function in this instance. 

Estrogens should be administered 
cyclically, simulating the physiological 
release of hormone by the body for 
example, three weeks administration 
followed by one week s rest. This 
pattern avoids continual stimulation of 
the endometrium with its attendant 
dangers: hyperplasia and neoplasia. 
The smallest effective dose is the 
maximum dose that should be used. 

Duration of treatment is governed 
by clinical response and evidence of 
maturation of the vaginal tract. Theo 
retically a patient can be treated in- 

FEBRUARY 1967 



definitely but as a general rule this is 
unnecessary. 

Complications 

Estrogen administration, especially 
in. synthetic form, is accompanied by 
nausea and vomiting in a certain 
number of patients. A weaker dose 
or the use of natural estrogens fre 
quently overcomes the difficulty. The 
main problem for the woman with 
an intact uterus is vaginal bleeding. 
Investigation to rule out the possibility 
of organic etiology is indicated, other 
wise a decrease in the dosage of es 
trogen or the addition of androgens 
frequently eliminates this complication. 
Such bleeding is always a source of 
anxiety and should never be treated 
lightly. 

Contraindications 

A careful assessment of the patient s 
physical state should precede the de 
cision to prescribe estrogen therapy. 
A past history of breast cancer or 
cancer of the genital tract precludes 
estrogen administration. The presence 
of carcinogens in this hormone has 
not been proven but laboratory find 
ings and the clinical effects observed 
in relation to breast cancer indicate 
the need for extreme caution. Patients 
with a history of cardiac failure must 
also be excluded from such treatment. 
Any patient who complains of menor- 
rhagia or metrorrhagia at the time of 
or after the menopause should have 
complete medical investigation in 
cluding gynecological examination, va 
ginal cytology, and, in many instances, 
uterine curettage to rule out the pres 
ence of other disease entities. 

Estrogens are contraindicated in 
the presence of jaundice or hepatic 
dysfunction. Liver function tests are 
recommended even in the absence of 
overt symptoms. Most doctors hesitate 
to prescribe estrogens if the patient 
has had thrombo-embolism or is suf 
fering form thrombophlebitis or vari 
cose veins. They exercise great caution 
if there is evidence of cardiac or renal 
disease, hypertension, epilepsy, or 
asthma. The possible effects of hor 
monal administration on calcium and 
phosphorus metabolism must not be 
overlooked in those patients demons 
trating irregularities in metabolism of 
these substances. 

The development of severe head 
ache, impaired vision, migraine, di- 
plopia, or any other neuro-ophthalmo- 
logical condition requires immediate 
withdrawal of estrogen therapy. The 
same procedure applies if changes in 
the visual field, retinal hemorrhage or 
papillary edema are detected. 

In the case of the diabetic patient, 
estrogen therapy may alter insulin 



requirements. The woman who has had 
an earlier psychiatric problem, par 
ticularly a depressive state, must be 
carefully supervised throughout her 
course of therapy. Any indication of 
recurrence of the psychiatric condition 
requires immediate cessation of hor 
monal therapy. 

Non-hormonal therapy 

About 75 to 80 percent of meno- 
pausal women retain an adequate pro 
duction of estrogens as has been 
proven by vaginal cytology; either the 
ovaries are not totally atrophied or 
estrogen production is taken over 
by the adrenal glands. Explanation 
and reassurance are two of the great 
est aids to these patients with occa 
sional recourse to light sedation or 
mild doses of tranquilizers. 

Conclusion 

The successful management of the 
menopausal syndrome calls for good 
sense, sympathy, and patience. Com 
plete opposition to the use of hor 
monal therapy is as much to be de 
plored as empirical administration to 
every menopausal patient. The latter 
philosophy seems particularly unjus 
tified when it is remembered that less 
than one-quarter of menopausal 
women exhibit signs and svmptoms of 
hvpoestrinism. The administration of 
hormones must be undertaken thought 
fully, ?nd carefully supervised as the 
foregoing consideration of contraindi 
cations to hormonal therapy and the 
precautions to be taken has indicated. 

n 



THE CANADIAN NURSE 39 



Nurse and pharmacist 
partners 

The mutual responsibilities of pharmacy and nursing in drug distribution. 



Jack L. Summers 



Drug distribution may be described 
as the procedure by which a drug gets 
from outside of the hospital to the 
inside of the patient, with the primary 
object of getting the right drug into 
the right patient at the right time. 

The total process involves the phy 
sician, the nurse, the pharmacist, and 
the patient. The physician plans the 
course of drug therapy and evaluates 
its results, the pharmacist dispenses 
the required drugs, the nurse adminis 
ters them, and the patient, in most 
cases, accepts them with trusting re 
signation. But this statement is an 
oversimplification for in the modern 
hospital a horde of people are involved 
in the execution of any single task. 
It has been estimated that more than 
20 different people are involved at 
one time or another in the procedures 
for getting a single dose of a drug 
into a patient. 1 

The responsibilities of nursing and 
pharmacy in the drug distribution pro 
cess have been delineated as adminis 
tration and dispensing respectively. 
However, these activities do not take 
place in a vacuum; they are interde 
pendent and frequently overlap. Nor 
do they always take place in complete 
harmony. One administrator has been 
driven to write that "many adminis 
trators agreed that if they could get 
pharmacy and nursing to cooperate 
fully, many other problems would dis 
solve."- Life should be so simple! 

The aim of this paper is to exa 
mine those areas of drug distribution 

40 THE CANADIAN NURSE 



which are of mutual concern to phar 
macy and nursing, some of the prob 
lems which arise, and some means of 
minimizing these problems. 

Methods of dispensing 

Two basic systems of dispensing 
drugs have been in use in hospitals for 
many years: the floor stock system and 
the individual prescription system. 

The Floor Stock System is one in 
which all but infrequently used drugs 
are stocked on the nursing station. 
While this system provides the nurse 
with an immediate supply of most 
drugs, it is costly in terms of nursing 
time, space requirements, and inven 
tory, and it lacks control. 

In the Individual Prescription Sys 
tem practically all medication orders 
are dispensed by a pharmacist in the 
form of an individual prescription for 
a specific patient. This system pro 
vides a high degree of inventory con 
trol and ensures that the physician s 
drug orders have been interpreted by 
a pharmacist. But the system requires 
a great deal of dispensing time without 
a compensating reduction in nursing 
time. And unless the system functions 
with flawless precision, a most un- 

Mr. Summers is Professor of Pharmacy, 
University of Saskatchewan. He is also Edi 
tor of The Hospital Phamacist, and until 
recently, Assistant Director, University Hos 
pital, Saskatoon. He served on the Com 
mittee on Nursing Education that prepared 
the Tucker Report. 



likely event, there are delays in the 
arrival of medications at the nursing 
units. This system was popular when 
patients were charged for individual 
medications, a situation which still 
exists in some hospitals in the United 
States. 

The system now in use in most Ca 
nadian hospitals is a combination of 
the floor stock and individual pres 
cription systems. A limited number of 
frequently used drugs, not commonly 
considered prescription drugs, are 
maintained as floor stocks. These in 
clude analgesics, laxatives, antiseptics, 
and intravenous fluids. The remaining 
drugs are supplied on an individual 
prescription basis. 

Some interesting work is being done 
in the development of more effective 
systems of drug distribution. However, 
this work is largely experimental and 
at the present time no practical alter 
native to the traditional systems is 
readily applicable to Canadian hos 
pitals. 

Drug order cycle 

From the time that a drug is 
ordered by a physician until it is ad 
ministered to the patient, a sequence 
of events takes place which, for the 
want of a more descriptive term, shall 
be called the drug order cycle. A brief 
examination of these events will illus 
trate the involvement of pharmacy and 
nursing. 

The physician decides on a 
course of drug therapy and orders the 

FEBRUARY 1967 



drugs to be administered to his pa 
tient. This information is communi 
cated to the nurse and entered in the 
patient s record. 

The drug is ordered from phar 
macy. If the drug is maintained as 
floor stock, the request to pharmacy 
is in the form of periodic requisitions 
for floor stock replenishment. If the 
drug is not in the ward stock, an in 
dividual prescription order is transmit 
ted to pharmacy. This may involve the 
nurse in recopying the physician s 
original order. 

When the prescription order is 
received in pharmacy, it is interpreted, 
and the appropriate drug selected, 
packaged, and labeled. 

The completed drug order is re 
turned, hopefully to the floor from 
which it originated. 

When the completed drug order 
arrives at the nursing station, it is 
scheduled for administration according 
to the physician s instructions. This 
procedure involves checking the ori 
ginal order, storage of the drug, and 
the creation of medication tickets. 

At the appointed time, a single 
dose of the drug is prepared for ad 
ministration, taken to the right patient, 
and administered by the appropriate 
route. But the administration of the 
drug is not the end of the cycle. 

The nurse observes the effects 
of the drug on the patient who may 
respond favorably, or adversely, or 
not at all. Regardless of its nature, the 
response of the patient is of impor 
tance to the physician and is record 
ed and communicated to him. 

At regular intervals the physician 
evaluates the effects of the drug the 
rapy and orders that it be continued, 
or altered, or discontinued. At this 
point the cycle ends and may be re 
peated. 

The number of separate events in 
the drug order cycle is appalling. With 
the possibility of error accompanying 
each event and the introduction of 
each new person into the interpretation 
and transmission of the physician s 
order, the wonder is not that there 
is an occasional error but that there 

FEBRUARY 1967 



are not more of them! And in ad 
dition to being subject to errors, this 
complex procedure is excessively de 
manding of the time of the nurse. 

Problem areas 

It would be kind to say that the 
prevalent systems of drug distribution 
are cumbersome. But what are the 
alternatives? 

Two approaches appear to be open: 
Adopt an entirely new system of drug 
distribution which will eliminate the 
present difficulties, and probably in 
troduce an entirely new set of prob 
lems; and improve the traditional sys 
tems by simplifying procedures and 
utilizing better methods of communi 
cation. 

It has already been noted that, in 
spite of considerable work on new 
methods, there seems to be no prac 
tical alternative to the traditional sys 
tems of drug distribution for most 
hospitals at this particular moment. 
Thus, the most productive approach 
for the immediate future appears to 
be the modification of existing systems 
to reduce the number of steps and 
people involved in the process. These 
changes should aim at reducing the 
possibility of medication errors and 
relieving the nurse of as much detail 
as possible so that she will have more 
time to spend with her patients. 

If significant improvements in the 
present methods of handling drug 
orders are to be effected, a clearer 
picture of the problem areas which 
are of mutual concern to nursing and 
pharmacy is necessary. Let us examine 
some of these areas in detail. 

Origin and transmission of individual 
prescription orders 

It is common practice for the phy 
sician s orders to be written in an 
order book. Drug orders are then 
transcribed by the nurse to individual 
prescription forms and transmitted to 
pharmacy for dispensing. 

While the initiation of the physi 
cian s order directly involves the nurse 
and the physician, it is important to 
the pharmacist that there be no ambi 
guity about the intention of the phy 



sician. The order should include the 
name of the drug, the dosage form, 
the dose, the route of administration, 
and the duration of therapy. If prob 
lems arise at this stage, the remainder 
of the process is an exercise in error 
which may harm the patient. 

In an attempt to overcome errors 
of interpreting drug nomenclature, 
some hospitals require the attending 
physician to print the name of the drug 
in the order book or on a special drug 
order sheet. But even when the name 
of the drug is perfectly legible, errors 
of intent may occur. 

Recently a physician intended to 
order Placidyl* - - a non-barbiturate 
sedative but Flaxedil** a potent 
muscle relaxant used to supplement 
general anesthetics was written in 
the order book. The order was ques 
tioned by the pharmacist, checked by 
the nurse against the order book, and 
the drug sent to the ward. The drug 
was subsequently administered to the 
patient who developed acute respira 
tory distress. The situation was rec 
tified by the prompt action of the 
nursing staff, but it provided an ex 
cellent lesson to both pharmacy and 
nursing. The pharmacist should have 
been aware of the fact that potent 
muscle relaxants are normally used 
only in the operating theaters, and the 
drug should not have been delivered 
without checking with the physician. 
However, the example is not cited to 
be critical of judgments but rather 
to illustrate that the intention of the 
physician is of mutual concern to the 
pharmacist and the nurse. 

The practice of transcribing the 
physician s original order, usually by 
a nurse, to a prescription form for 
subsequent transmission to pharmacy 
is questionable. It introduces a pos 
sibility of error in transcription, a 
source of additional work, and several 
more pieces of paper to clog the 
machinery of drug distribution. 

*Placidyl registered trade name for Ab 
bott Laboratories brand of ethchlorvynol. 

**Flaxedil registered trade name for 
Poulenc Limited brand of gallamine triethi- 
odide. 

THE CANADIAN NURSE 41 



The transmission of drug orders 
can be simplified by the use of a du 
plicate drug order that provides a copy 
for the nurse and a copy for the phar 
macist which serves as a prescription 
requisition. This procedure eliminates 
the recopying of drug orders and gives 
the pharmacists the physician s original 
order for interpretation. Questions re 
garding the order may be discussed 
directly with the physician by the phar 
macist, keeping in mind that nursing 
must be informed of any change in 
the original order. 

A drug order form that appears to 
solve many of the problems of trans 
mitting the physician s original order 
to pharmacy has been developed and 
used by Joseph Brant Memorial Hos 
pital 3 . 

Regardless of the system used for 
ordering a drug from pharmacy, the 
actual transfer of the order should not 
require a nurse, or a member of her 
staff, to deliver it to pharmacy. The 
pneumatic tube, or other automated 
transport device, provides a conven 
ient delivery system. In older hos 
pitals, the use of a routine drug or 
der pick-up service, supplemented by 
telephone and pharmacy runner, 
should make the use of nursing staff 
as messengers an outmoded form of 
communication. 

Prescription labeling 

Dispensing is the role of the phar 
macist. While there is little mutual 
concern with this phase of operations, 
the labeling of the prescription is of 
some importance to the nurse. The 
label should provide her with suffi 
cient information to get the right drug 
into the right patient. In hospitals, it 
is customary to label the prescription 
with the name and location of the 
patient, the name of the prescribing 
physician, and the name and strength 
of the drug. Directions are omitted 
unless specifically requested because 
the nurse has a number of orders, 
card files, medication tickets, and 
other assorted sources of information 
that give her the dosage schedule of 
the drug order. One more source of 
information would but add to the con 
fusion. 
42 THE CANADIAN NURSE 




The name of the drug which ap 
pears on the label frequently poses a 
problem to the nurse. Drug nomen 
clature, being the jungle that it is, 
makes it possible to label a drug with 
a variety of names, all of which may 
be different from the name by which 
the physician ordered the drug. The 
nurse is not an expert in drug nomen 
clature and it should not be necessary 
for her to search reference works to 
verify the fact that the name on the 
label is synonymous with that by 
which the drug was ordered. 

The source of the problem is that, 
if a physician orders a drug by its 
trade name, and a brand of the drug 
other than that called for by the trade 
name is supplied, the prescription 
cannot legally or ethically be labeled 
with the brand name specified in the 
physician s original order. In such 
cases the common name of the drug 
should be used to identify the drug 
supplied. But when this is done, the 
label should also read "Dispensed in 
place of (brand name specified by 
physician)." Thus the nurse does not 
have to guess at the meaning of the 
common name nor phone to the phar 
macy to see why Mrs. Jones order has 
not arrived! 

It must be emphasized that the dis 
pensing of a brand of drug other than 
that specified in the physician s order 
may only take place with the approval 
of the physician, or under the author 
ity of the Pharmacy and Therapeutic 
Committee of the Medical Staff. 



Prescription delivery 

Once a drug order has been trans 
mitted to pharmacy the nurse should 
be relieved of further responsibility 
until the drug arrives back on her 
ward in time to meet the needs of the 
patient. But all too frequently things 
don t happen quite this smoothly and 
there is a last minute panic to locate 
a drug which has been, or should 
have been, ordered some time pre 
viously. 

Drug orders arrive at the pharmacy 
like bananas in bunches and the 
pharmacist must attempt to place a 
realistic priority on their completion. 
Some means of indicating emergency 
orders for immediate return to the 
ward should be worked out between 
pharmacy and nursing. "Stat" orders 
should not be abused to expedite the 
delivery of non-urgent drug require 
ments. 

The mechanics of delivering drug 
orders to the wards are unimportant 
providing that they are convenient for 
both nursing and pharmacy, and get 
the drugs to the ward in time for ad 
ministration. Delivery may be achieved 
by pneumatic tube, or some automatic 
conveyor system, by a routine delivery 
service, or pharmacy runner, or a 
combination of methods. But the me 
thod should meet the requirements of 
the particular hospital and deliver the 
goods - - on time. It is the responsi 
bility of the pharmacist to ensure that 
it does so! 

FEBRUARY 1967 



After-hour pharmacy service 

While most of the problems of mu 
tual concern to pharmacy and nursing 
arise in the course of the drug order 
cycle, several additional areas con 
tribute their share of headaches. After- 
hour pharmacy service is a fairly con 
sistent source of distress. 

The pharmacy department is open 
and fully staffed for a definite period 
of time each day. On weekends and 
holidays a reduced staff is usually 
present at certain times to provide for 
the immediate requirements of the pa 
tient. 

The hours of operation of the phar 
macy should reflect the demands for 
service. More than 90 percent of new 
drug orders originate between the 
hours of 8:00 A. M. and 5:00 P. M. 
Monday to Friday, and this factor de 
termines the hours of full operation. 
However, in some hospitals the medi 
cal staff make rounds in the early 
evening after office hours. This prac 
tice creates a number of new drug or 
ders and it is reasonable to expect 
pharmacy to provide service over this 
period. 

But, illness in general, and emergen 
cies in particular, have refused to ob 
serve the sanctity of the 40-hour week, 
and hospitals are required to function 
24 hours a day for seven days each 
week. Drugs are required after the 
pharmacy is closed for the day and 
there must be some procedure for ob 
taining adequate pharmacy service 
after regular hours. 

The aim of after-hour pharmacy ser 
vice is to provide the nurse with those 
drugs that are necessary to meet the 
immediate requirements of the patient 
without undue inconvenience to the 
nursing staff. Under no circumstances 
should the nurse be required to engage 
in dispensing. The system should en 
sure that a pharmacist is always avail 
able to discuss medication problems 
with the nurse, and to return to the 
hospital if the occasion demands. 

The ideal solution to after-hour ser 
vice is to have the pharmacy open 
for 24 hours a day. For some larger 
hospitals this approach is a sensible 
solution; for some it is a necessity! 
However, for most hospitals, 24-hour 
operation of the pharmacy department 

FEBRUARY 1967 



is neither practical nor necessary. But 
the responsibility for 24-hour phar 
macy service must rest with the phar 
macist and it is his task to come up 
with a suitable answer to his own par 
ticular situation. 

The use of an emergency drug sup 
ply for after-hour drug requirements 
is a common practice. The nurse, or 
more specifically the evening or night 
supervisor, is expected to go to the 
supply, select the right package, and 
leave a requisition for what she has 
taken. 

While this system does meet a need 

the need for drugs in an emergency 

it is time-consuming and cumber 
some for the nurse. Indeed, it is diffi 
cult to consider it as a service. The 
emergency drug system is much too 
often used as a substitute for adequate 
pharmacy service. 

Most medium-sized hospitals require 
something between full-time pharmacy 
service and the night supervisor as 
suming full responsibility for the dis 
pensing of after-hour drugs. There are 
many ways in which the required ser 
vices can be provided, short of 24- 
hour pharmacy staffing. The extension 
of pharmacy hours on a reduced staff 
basis to cover busy evening periods 
and weekends, a pharmacist on call, 
utilization of retail pharmacists, and 
conveniently located pre-packaged 
emergency drug supplies may all con 
tribute part of the solution. A combi 
nation of these methods should pro 
vide a satisfactory after-hour pharma 
cy service for most hospitals. But the 
degree of service required by a hos 
pital after hours, and the adequacy of 
the measures for providing it, should 
be arrived at by consultation between 
pharmacy and nursing. 

Ward stock medications 

The pharmacist is responsible for 
all drugs in the hospital, regardless of 
their location. This includes drugs 
maintained as ward stocks. 

There are two areas of mutual con 
cern to the nurse and the pharmacist 
relative to ward stocks. The first is 
the list of drugs to be kept on wards 
and the second is the procedure for 
replenishing stocks of these drugs. 

The purpose of ward stocks is to 



provide the nurse with a convenient 
supply of most items used in routine 
performance of nursing care. Require 
ments for ward medication should be 
maintained without a complicated re 
quisitioning and accounting system 
and without the nurse being required 
to move from the ward to obtain sup 
plies. 

The selection of drugs for each ward 
should be worked out between the 
pharmacist and the head nurse of the 
particular ward because requirements 
vary from ward to ward. While the 
nurse may prefer to have all of her 
drug requirements readily at hand, 
there is some limit, short of the entire 
dispensary inventory, that must be 
accepted as reasonable. Floor stocks 
should not be considered as an inflex 
ible list of drugs but rather a group 
of drugs that may be augmented or re 
duced to meet current fashion of drug 
therapy and the type of patient on the 
ward. 

Expensive drugs that may be readily 
consumed by other than patients, such 
as antibiotics, should not be requested 
as ward stocks. Large ward stocks 
require an increased inventory which 
defeats the purpose of central drug 
control, and, indeed, add to the con 
fusion of preparing medications for 
patients. 

To reorder ward stocks, the most 
that should be required of the nurse 
is to check off a preprinted form. The 
responsibility for picking up orders and 
delivering the drugs to the ward at 
a convenient time rests with the phar 
macist. 

Some hospitals no longer use ward 
stock requisitions. The pharmacist 
brings the drugs to the wards, checks 
the existing supplies, and brings them 
up to a scale of issue previously agreed 
upon with the staff of the nursing 
unit. A modification of this system is 
a mobile ward stock unit which is 
wheeled up to the ward to replace the 
old unit which is taken back to the 
pharmacy for replenishment. 4 

Narcotic control 

The responsibility for accounting 
for narcotics and "controlled" drugs 
falls upon both the pharmacist and the 
nurse. 

THE CANADIAN NURSE 43 



While the law is quite specific as to 
what must be done, pharmacy and 
nursing can work together to develop 
procedures which fulfill both the letter 
and the spirit of the regulations with 
out creating too great an inconve 
nience to either profession. 

Requisitioning procedures should 
require only the signature of the head 
nurse or her deputy. The requested 
narcotics and controlled drugs may 
then be delivered to the ward at a 
convenient time each day. Nursing 
units should stock adequate supplies 
of narcotics and controlled drugs and 
should not be required to return an 
empty container before being allowed 
to reorder a second. This makes it 
possible for the nurse to plan her nar 
cotic orders on the basis of a 24-hour 
requirement and prevents needless 
trips and requisitions by both pharma 
cy and the nursing unit. 

It should not be necessary for the 
nurse to return the completed record 
of administration to the pharmacy per 
sonally unless some problem has ari 
sen. Under normal circumstances, it 
should be sufficient for both records 
and containers to be picked up by 
pharmacy when narcotics are deli 
vered, or sent back with the normal 
drug returns. 

A shift count of narcotics is some 
times required by nursing service. The 
merits of this particular form of enter 
tainment will not be debated at this 
point. But where such a procedure is 
required, it is helpful if narcotics are 
packaged in such a manner that indi 
vidual doses can be seen and counted 
without removing them from the con 
tainer. This prevents wear and tear on 
both narcotics and nursing tempers. 
Many such containers are now availa 
ble and there is no valid reason for 
not putting them to use. 

Nursing may greatly assist in the 
control of these drugs by bringing 
problems to the attention of the phar 
macist as soon as they are suspected. 
Narcotics that have not been used for 
some time should be returned to the 
dispensary rather than left on the ward 
for daily counting. 

Developments in drug distribution 

It is becoming increasingly obvious 

44 THE CANADIAN NURSE 



that the traditional methods of drug 
distribution are no longer adequate 
to meet the requirements of the mod 
ern hospital. The most significant 
reasons are said to be: 

1. The high percentage of medica 
tion errors reported in the literature 
and 

2. the widespread shortage of per 
sonnel, especially nurses. 5 

Work is being done on the develop 
ment of several new systems of drug 
distribution, most of which are based 
on the unit-dose system of dispensing. 
In this system, all drugs are delivered 
to the floor in single doses, labeled 
for specific patients, and ready for 
administration, immediately prior to 
the time at which they are to be ad 
ministered to the patient. All that is 
required of the nurse is to take the 
prepared medication to the right pa 
tient and administer it. 

The successful introduction of such 
a system will require considerable 
mental and mechanical adjustment on 
the part of both nursing and pharma 
cy. But regardless of the problems in 
volved, few should quarrel with the 
object of the system, which is to re 
lieve the nurse of many of the time- 
consuming mechanical details which 
now keep her from the patient. It 
should also contribute to a reduction 
of the volume of waste paper which 
now accumulates in the nursing sta 
tion. 

Automated dispensing units of the 
vending machine type have been intro 
duced in an attempt to improve drug 
distribution techniques. While this de 
vice does have some very desirable 
features, it does little to improve the 
lot of the nurse. Indeed, this type of 
equipment is now obsolescent in the 
light of newer developments. 

Some of the more sophisticated ad 
vanced systems incorporate the utiliza 
tion of automatic data processing 
and telecommunications. Not only 
does the system deliver the required 
drugs in unit doses, but sends a mes 
sage reminding the nurse that medica 
tion is due for certain patients whose 
names are printed out. The machine 
calls back in 15 minutes to ask if the 
task has been completed. 7 

One of the new developments al 



lows the physician to select and or 
der his drug therapy on a device si 
milar to a television screen. One gets 
the impression that the nursing station 
in the automated hospital will resemble 
a fire control unit of a nuclear bat 
tleship. 

Many of the experimental systems 
being tested at the present time will be 
applicable only to specialized hospi 
tals. But out of the present work will 
evolve a new system, or systems, 
which will be applicable to all hospi 
tals, and which will solve many of the 
problems which beset both pharmacy 
and nursing in the process of drug 
distribution. 

Until new systems are developed, 
there is much that can be done to im 
prove the present methods of providing 
drugs for patients. But to do so will 
require a genuine effort on the part 
of nurses and pharmacists to become 
familiar with their areas of mutual 
responsibilitv and to minimize the 
causes of friction which are irritating 
to ourselves and detrimental to the 
welfare of our patients. 

But regardless of the development 
of new systems, the introduction of 
automation, and the use of automatic 
data processing, the pharmacist will 
not provide the nurse with the assis 
tance which she requires, and which 
he is capable of providing, until he 
moves out of the dispensary to where 
the action is on the wards of the 
hospital. The shiny new tools and 
gadgets, from which so much is ex 
pected, must be looked upon as a 
means of helping to achieve this aim. 

References 

1. Latiolais, C.J. Hasp. Manag. 94: 80, 
Sept. 1964. 

2. Biggs, E. L. The Administrator-Pharma 
cist Relationship. Canad. Hasp. 43: 44, 
June 1966. 

3. Smythe, H.A. Hosp. Pharm. 19: 103, 
May-June 1966. 

4. Victorine, Sister M. Amer. J. Hosp. 
Pharm. 15: 973, Nov. 1958. 

5. Stauffer, I.E. Hosp. Pharm. 19: 149, 
July-Aug. 1966. 

6. Barker, K.N. and Heller. W.M. Amer. 
J. Hosp. Pharm. 20: 568, Nov. 1963. 

7. Jang, R. and Barker, K.N. Mod. Hosp. 
p. 124, April 1965. D 

FEBRUARY 1967 



Tumors of the skin 



A brief description of the benign and malignant tumors of the skin, 
and their treatment. 



P.J. Fitzpatrick, M.B., D.M.R.T., F.F.R. 



Tumors of the skin are very com 
mon, usually occurring on exposed 
surfaces such as the face or the back 
of the hands, but can appear anywhere, 
particularly if the site is subject to 
persistent trauma. Exposure to wind, 
sun, and frost are etiological factors, 
and skin tumors are more common in 
the white populations living in tro 
pical climates and in persons such as 
farmers or fishermen who work outside. 

Tumors may be benign or malig 
nant, are often multiple, and seen more 
frequently in the older age groups. 
Some benign lesions become malignant 
with time, and, although most malig 
nant tumors arise primarily in the skin, 
occasionally they are a manifestation 
of widespread cancer. Metastases from 
breast and lung tumors are the com 
monest and the malignant lymphomata 
can infiltrate the skin. 

Skin cancer usually implies tumors 
of epithelial origin and may be clas 
sified according to histological charac 
ters. They are generally of low-grade 
malignancy and the majority are cured 
at the first attempt. Where the first 

The author expresses his appreciation to 
Mrs. M. Gaettens of the Department of 
Medicine Photography, The Princess Mar 
garet Hospital, for providing the clinical 
photographs, and to Mrs. M. Mclntyre for 
her secretarial and typing services. 

Dr. Fitzpatrick is radiotherapist at The 
Princess Margaret Hospital, Toronto. On 
tario. 

FEBRUARY 1967 



planned treatment fails to cure the pa 
tient, secondary measures are usually 
effective and few patients succomb to 
this disease. 

Benign tumors 

These lesions tend to have a long 
history. They "sit on" the skin rather 
than invade it, are frequently pigment- 
ed and multiple, involving large areas. 
The commonest is the hyperkeratosis 
(Figure 1) which presents as a rough 
ened area of thickened skin and may 
show ulceration; in time, these may 
develop into squamous cell carcino 
mas. Bowen s disease is intraepithe- 
lial carcinoma that tends to occur at 
mucocutaneous junctions, particularly 
around the anus and the lip; these le 
sions, too, sometimes progress to frank 
squamous cell cancer. The keratoacan- 
thoma (Figure 2) is an interesting 
tumor that is often misdiagnosed for 



the more serious epithelioma. The 
history is short, often of only a few 
weeks duration, with rapid growth 
commencing as a pimple that breaks 
down in the center to show a keratin 
plug. On separation this leaves an ul 
cerated, indurated base; left to itself, 
spontaneous healing will occur with 
an average life of 12 to 25 weeks 
(Figure 3). Other benign tumors are 
mentioned for completeness but are 
outside the scope of this article (Figures 
4, 5, 6). 

Malignant tumors 

Basal Cell Carcinoma 

The rodent ulcer is the commonest 
malignant tumor of the skin. Its site 
of election is the face above a line 
joining the lobe of the ear to the angle 
of the mouth, particularly at embryo- 
logical junctional areas. The tumor 
erodes away at tissues, but does not 



Common Primary Skin Tumors 



BENIGN 



Keratosis 

Wart 
Angioma 

Keloid 

Nevus (Mole) 
Keratoacanthoma 



MALIGNANT 



Basal Cell Carcinoma 

(Rodent Ulcer) 
Squamous Cell Carcinoma 

(Epithelioma) 

Malignant Melanoma 

Bowen s Disease 



THE CANADIAN NURSE 45 



metastasize and usually is not a serious 
condition, although large tumors can 
produce hideous deformities. It starts 
as a small lump that breaks down in 
the center and refuses to heal. Growth 
is slow and the edges of the tumor 
are pearly white in appearance with 
numerous small blood vessels present. 

Squamous Cell Carcinoma 

Epithelioma frequently arises in as 
sociation with other skin changes due 
to climatic exposure or trauma. It is 
therefore more common on exposed 
parts of the body and grows directly 
by extension into the surrounding tis 
sues, sometimes metastasizing to the 
regional lymph nodes. It starts as a 
pimple or ulcer that will not heal and 
growth may be rapid. The edges of 
the ulcer are raised, rolled, and everted 
and the base bleeds easily (Figures 
7, 8, 9, 10). 

Malignant Melanoma 

This tumor is less common than the 
epithelioma and may occur anywhere 
on the skin, most commonly around 
the orbit or on the limbs. It has a 
sinister reputation because of its black 
color and its tendency to recur locally 



if inadequately treated. There is a high 
incidence of metastases that may ap 
pear as satellite nodules around the 
primary tumor (Figure 11) or spread 
through the lymphatics to the regional 
nodes. Involvement of other organs, 
particularly the lungs and liver due to 
bloodstream spread, is common. The 
tumor is not always pigmented and it 
may follow change in a benign nevus; 
occasionally there is a history of rapid 
growth or bleeding associated with 
pregnancy. This tumor carries the 
worst prognosis of any skin tumor. 

Patient management 

At The Princess Margaret Hospital, 
patients are seen in a special skin clinic 
where a history is taken and clinical 
examination carried out. Following 
this a diagnosis is made which is usual 
ly followed by a biopsy to confirm the 
clinical impression. A photograph is 
useful in following the subsequent 
progress of the tumor and occasionally 
x-rays are required to see whether 
there is any bone destruction or to 
search for the presence of metastases. 

Irradiation has been used in the 



treatment of skin tumors for over 60 
years. The therapeutic use of radiation 
depends on its ability to destroy se 
lectively abnormal tissue without dam 
aging the adjacent normal structures. 
This is accomplished by various treat 
ment techniques and the physical pro 
perties can be adapted to suit any 
tumor and site. Many techniques have 
been used and the radiation obtained 
from radioactive isotopes or x-ray ma 
chines. Radium has been the isotope 
used most extensively and is still used 
in the form of needles that can be im 
planted into the tumor, or as a sur 
face applicator; however, these now 
have been replaced for the most part 
by external irradiation from an x-ray 
machine. 

Radio-isotopes emit radiation of dif 
ferent types by disintegration of the 
nucleus, the gamma ray being used for 
therapeutic effect. These rays are simi 
lar to x-rays and related to those of 
light, heat and radio, but are of ex 
tremely short wave lengths. Radiation 
is absorbed in tissues and its depth 
of penetration depends on several fac 
tors. In general, the higher the voltage 




Fig. 1: Seborrhea keratosis on the left 
cheek of a 66-year-old farmer. It was 
present for 2 years, growing slowly, 
and bleeding at touch. Treated with 
single shot of irradiation. 

Fig. 4: Keloid scar on the back of lobe 
of an ear following piercing. No 
treatment given. 



Fig. 2: Keratoacanthoma on nose of a 
57-year-old man. Present for 6 weeks, 
growing rapidly, but not bleeding. 
Treated with simple curettage. 

Fig. 5: Angioma on the head of a 
2-month-old baby. Tumor disappeared 
spontaneously without treatment over 
a 3-year period. 



Fig. 3: Same patient as in Figure 2, 
jour months later. 



Fig. 6: Benign papilloma in the left ear 
of a 72 -year-old man. Present most of 
his life but recent bleeding due to 
trauma. Tumor removed by curettage. 








46 THE CANADIAN NURSE 



FEBRUARY 1967 



the greater the depth dose achieved. 
Thus, at 100 KV, the useful depth of 
irradiation is about 4 mm.; deeper 
tumors have to be treated with more 
powerful units. 

Rodent ulcers and epitheliomas are 
moderately radiosensitive and can be 
readily destroyed by radiation. If the 
tumor is small, a single treatment will 
suffice and is useful in treating old 
people, especially if they have had to 
travel from afar. Larger tumors have 
to be treated over several days to get 
a cancericidal dose that will not dam 
age the normal surrounding structures. 
A better cosmetic effect is obtained 
and the chances of getting a geogra 
phic miss, possible with a single shot 
treatment, eliminated. 

Most tumors are superficial and low 
voltage x-ray machines operating at 
less than 100 KV provide effective 
treatment. For thicker lesions a higher 
voltage at 250 KV is required. Today, 
high energy electrons and other radio 
active isotopes, such as Caesium 137, 
increase our therapeutic armory. 

Following irradiation, the tumor 
develops an erythema and subsequent 



ly becomes covered with a yellow fi- 
brinous exudate; this reaches its maxi 
mum intensity after about two to three 
weeks and becomes slightly sore. 
Crusting follows. On separation four 
to six weeks following therapy, the 
tumor is found to have disappeared, 
although complete resolution some 
times takes a little longer. The cosme 
tic result is usually good and repre 
sented by minor atrophy of the skin, 
although telangiectasia may occur after 
treatment of large tumors many years 
later. Recurrence is uncommon and 
probably best treated by excision be 
cause of the danger of necrosis fol 
lowing heavy irradiation. The latter 
follows damage to the blood vessels 
of the skin which develop an endarte- 
ritis with subsequent deficient nourish 
ment and oxygenation of the involved 
area. 

Unfortunately the malignant melano 
ma is not a radiosensitive tumor, al 
though small ones can be destroyed by 
heavy irradiation. These tumors are 
best excised and it is generally accept 
ed that any excision that does not re 
quire skin grafting is inadequate. Irra 
diation is used to supplement surgery 



where the latter may have been in 
complete, and is useful in palliating 
the symptoms of advanced disease. 

The techniques used at The Princess 
Margaret Hospital and the common 
reactions encountered and their man 
agement will be described in the fol 
lowing article. After treatment, skin 
tumors are followed in the outpatients 
clinic to assess the result. 




Fig. 7: Epithelioma on left hand of 
a 49-year-old laborer. Present for 8 
months and growing rapidly. Treated 
with radium mold. 



Fig. 10: Same patient as in Figure 9. 
Result shown 18 months later. 



Fig. 8: Same patient as in Figure 7. 
Result shown 4 years later. 



Fig. 11: Malignant melanoma on left 
foot of a 67-year-old man. Present for 
many years. Tumor excised and 
grafted, but patient died of distant 
metastases three years later. 



Fig. 9: Epithelioma lower lip present 
for 6 months. Treated with external 
irradiation. 




FEBRUARY 1967 



THE CANADIAN NURSE 47 



Radiation therapy for 
skin cancer 



Minimizing the patient s fear about the diagnosis of cancer and the method of 
treatment is a major responsibility of the radiotherapy technician. 



Doris Martyn, Reg. N., R.T. 



During the past eight years, one out 
of every five new patients registered 
at The Princess Margaret Hospital in 
Toronto had some form of skin cancer; 
in fact, nearly 5,000 new patients were 
seen and treated. 

Most patients are treated on an out 
patient basis; very few need to be ad 
mitted to hospital. If patients come 
from outside the city, they can be 
accommodated in The Princess Mar 
garet Lodge, which is situated about 
100 yards from the main hospital. 
Room and meals are provided at the 
Lodge, but the patient is able to go out 
and follow whatever pursuits he likes. 

The skin clinic in the outpatients 
department is staffed by a consultant 
dermatologist and radiotherapist. They 
examine each patient, make a diag 
nosis, and prescribe treatment. The 
patient is then escorted by a volunteer 
to the radiotherapy department and 
introduced to the radiographer who ex 
plains the course to be followed. 

Description of department 

The radiotherapy department is de 
signed to make treatments as efficient 
and pleasant as possible. Radiation 
used therapeutically produces no haz 
ard to the patient; but irradiation in 
small doses received over a long period 
of time by personnel working in the 
therapy departments is hazardous. Cer 
tain precautions are taken to mini 
mize exposure. The walls of the treat 
ment room are of thick concrete and 
the observation windows contain lead 
48 THE CANADIAN NURSE 



so that no stray radiation can filter 
to the outside. Because of the dangers 
of radiation exposure, the technician 
is not allowed to be in the room at 
the same time as the patient while 
treatment is being carried out, but ob 
serves him through the specially pro 
tected window. 

The treatment rooms are pleasantly 
decorated and spacious to prevent 
claustrophobia. As there are no out 
side windows, murals of outdoor scenes 
cover one wall. A two-way communi 
cation system has been set up so that 
technician and patient can converse at 
all times while therapy is in progress. 
To encourage relaxation, soft back 
ground music is piped into all treat 
ment rooms. 

Radiotherapy 

The doctor prescribes the amount 
and type of radiation required and 
specifies the area to be treated. This 
varies according to the nature of the 
tumor and its extent. The prescription 
is written on a special treatment sheet, 
and unless the treatment is compli 
cated or extends for more than five 
days, the doctor will not see the pa 
tient again until the first follow-up 
visit in the outpatient clinic. The radio 
grapher is now responsible for the 
planned treatment and for establishing 
rapport with the patient. 

Miss Martyn is Senior Radiotherapy Tech 
nician at The Princess Margaret Hospital. 
Toronto, Ontario. 



When external irradiation is to be 
used, the patient is placed on a treat 
ment couch with the appropriate area 
exposed. Treatment for each patient 
is individualized. The regular set of 
applicators are suitable for a good 
proportion of the patients, but some 
situations require special shields that 
can be made to any size or shape. 

Most skin cancers are treated with 
superficial x-ray at 100 kilovolt. A 
very thin sheet of lead (0.5 millimeters 
thick), which can be cut with scissors, 
prevents any radiation from passing 
through it. Large tumors are treated 
at a moderate voltage and the shield 
ing has to be thicker to prevent irra 
diation of the surrounding normal tis 
sues. The doctor will have marked the 
area to be treated with a skin pencil. 
This is then outlined with the appli 
cator or lead cut-out and the x-ray 
machine is placed in position. Patients 
who are comfortable will maintain 
their position better than those who 
are not, and if there is any danger of 
movement the part to be treated is 
supported by sand bags. 

The patient is told again that the 
treatment is painless but that there 
will be a whirring sound from the ma 
chine which is quite normal and no 
cause for alarm. The technician re 
treats from the room, shuts the door, 
calculates the treatment time, and 
turns on the radiation beam. Most 
treatments take only a few minutes. 
When the prescribed dose has been 
given, the machine automatically turns 
FEBRUARY 1967 




Fig, 1: A 52 -year-old man with ulcer 
below the left eye. The ulcer had been 
present for 1 year, was growing slowly, 
and bleeding on occasion. Biopsy 
confirmed the present of a rodent ulcer. 







Fig. 2: Same patient showing the area 
to be irradiated marked out and an 
internal eye shield in position. 







itself off and the technician re-enters 
the room, releases the x-ray applicator, 
and removes any shields. 

Protection badges worn 

To make sure that nurses and tech 
nicians do not receive irradiation 
beyond the maximum permissible level 
as outlined by the World Health Or 
ganization, protection badges are worn 
and blood counts taken periodically. 
The protection badge consists of a 
small x-ray film, which is sensitive to 
radiation. The badge is worn on the 
chest of the technician and any ex 
posure of radiation can be determined 
by the subsequent development of the 
film. 

Treatment of rodent ulcers 

Rodent ulcers around the eyelids 
are common. At this site special lead 
shields have to be placed inside the 
lids to protect the underlying eye 
(Figures 1, 2, 3, 4). The shields are 
made out of lead with the concave con- 
junctival surface coated with a thin 
layer of plastic. Several sizes and 
shapes are available and one is select 
ed to suit the patient. They are stored 
dry, but prior to use are soaked in 
1:750 solution of aqueous zephiran for 
half an hour and then rinsed in sterile 
water for five minutes. 

To anesthetize the eye we use 0.5 
percent pontocaine; two drops are 
placed in the lower conjunctiva! sac 
and repeated after five minutes. Five 
minutes later, the eye shield, lubri- 

FEBRUARY 1967 



cated with mineral oil, can be inserted 
by slipping it under the lower eyelid 
and lifting the upper eyelid over it. 
After treatment the shield is removed 
and 10 percent sulphacetamide drops 
are instilled into the lower fornix to 
prevent subsequent infection, together 
with one or two drops of mineral oil 
to minimize irritation. A pad and ban 
dage are applied until sensation has 
returned which usually occurs within 
one to two hours. Without the pro 
tective bandage, a piece of grit could 
lodge in the eye and produce damage 
without the patient being aware of it. 
If a single treatment has been pre 
scribed, the nature of the subsequent 
reaction is explained to the patient. 
If further treatments are planned, a 
return appointment is arranged to fit 
in with the patient s other commit 
ments, so as to disturb his normal 
routine as little as possible. 

Skin reactions to irradiation 

Within a day or two of being irra 
diated, the treated skin shows a faint 
erythema which increases over several 
days. This reaches a maximum inten 
sity after about 10 days, and a moist 
desquamation of the skin often occurs 
at this time. During this period, trauma 
to the treated area should be avoided 
and the affected skin kept dry. If dis 
comfort occurs, Nivea Creme or lano 
lin should be applied sparingly two 
or three times a day. If the reaction 
is unduly severe, as sometimes occurs 
in persons with fair or sensitive skin, 



one percent gentian violet solution ap 
plied two of three times a day will 
produce a scab and allow the under 
lying tissues to heal. 

Following moist desquamation, crusts 
appear; these are best left to separate 
on their own. Separation usually oc 
curs between the third and fourth 
weeks and a new pinkish skin is seen. 
The tumor will often have disappeared 
by this time, but sometimes a residuum 
is left. Further disappearance occurs 
during the next few weeks with no 
special treatment required apart from 
avoidance of trauma. 

The patient should be protected 
from sunlight, wind, and frost, since 
these can cause severe local reactions, 
manifested by redness, soreness, and 
weeping of the treated area, with de 
layed healing. Infection, too, must be 
avoided or increased scarring will re 
sult with impaired cosmetic result; the 
patient is advised against rubbing the 
area. If there is hair in the irradiated 
area, permanent epilation usually will 
result; although this is of little con 
sequence, the patient should be warned 
about it. 

The doctor examines each patient 
about two months following treatment 
to assess the result; however, he will 
see him before this time if the need 
arises. A careful explanation of the 
reactions that follow irradiation and 
a form that gives the patient general 
instructions on management of the 
treated area usually make this earlier 
visit unnecessary. 

THE CANADIAN NURSE 49 



Fig. 3: Patient being prepared for 
treatment. 




Dressings to irradiated areas are 
not required unless the patient is ex 
posed to trauma or dirt, in which case 
a simple cover minimizes the risk of 
infection. Follow-up of these patients 
is shared by the local doctor and the 
clinic. A patient with a rodent ulcer 
can usually be discharged from clinic 
follow-up after one year, but is ad 
vised to see his own physician if he 
notices any skin changes at the treated 
site or elsewhere. Follow-up after one 
year is unnecessary if the tumor has 
completely disappeared because late 
recurrence is rare. 

Other malignant tumors are followed 
indefinitely because of the possibility 
of local recurrence or the appearance 
of metastases. Because skin tumors are 
frequently multiple, the precipitating 
causes are explained to the patient and 
he is advised to protect himself as far 
as possible. 

Fears 

Many patients verbalize their fears 
and apprehensions to the nurse rather 
than to the doctor. Explanations and 
reassurance will allay these fears, but 
definite answers are needed for ques 
tions, such as "Will it burn?" 

During the Second World War, 
Norman Rockwell painted four can 
vases entitled "The Four Freedoms." 
One of these illustrates a basic need 
of all human beings: "Freedom From 
Fear." Fear of cancer is perhaps one 
of the most terrifying fears today. As 
nurses, we face the tremendous chal 
lenge of assisting a patient through the 
initial frightening phase following a 
diagnosis of cancer. We must try to 
give him peace of mind, a sense of 
security, assurance and hope. These 
things we have been trained to do; 
but to do it properly, we need to edu 
cate ourselves in the modern methods 
of therapy. D 



50 THE CANADIAN NURSE 



Fig. 4: Patient being treated. A lead 
cut-out is seen outlining the area to be 
irradiated. 

FEBRUARY 1967 



books 



Fundamentals of Public Health Nursing 

by Kathleen M. Leahy, R.N., M.S. and 
M. Marguerite Cobb, R.N., M.N. 225 
pages. Toronto, McGraw-Hill Book Com 
pany, 1966. 

Reviewed by Miss Margaret Steed, nursing 
consultant, education, Canadian Nurses 
Association, Ottawa, Ontario. 

This book was written to provide nursing 
students with the necessary guidelines in 
preparation for their experience in public 
health nursing. 

The content was developed specifically 
for use in baccalaureate pre-service pro 
grams, designed to prepare nurses for be 
ginning positions in public health nursing, 
but would be similarly applicable in a di 
ploma program in nursing where public 
health concepts are integrated throughout the 
nursing courses. 

The information in the textbook is pre 
sented in two parts. 

Part one is devoted to public health and 
public health nursing, the principles of 
public health nursing, together with history, 
trends and philosophy. Information is given 
specific to the home visit, and related to 
essential communication skills and statistics. 
The identification of the role of the public 
health nurse, as it is viewed on the health 
team, seems to require an excessive review 
of historical material. 

In part two, a variety of selected case 
situations and case records together with 
topics and questions suitable for discussion 
periods are offered. This part of the book 
adds to the true value of this basic textbook 
for nursing students, in that descriptions of 
actual situations experienced and problems 
encountered by public health nurses are 
narrated and designed to provide some 
insight into public health nursing and the 
skills, understandings, appreciations and 
awareness that are required and utilized. 

Geriatric Nursing, 4 ed, by Kathleen New 
ton, R.N., M.A. and Helen C. Anderson, 
R.N., P.T., M.N. 390 pages. Saint Louis, 
Mosby, 1966. Reviewed by Mrs. Valerie 
Nicholson, instructor, School of Nursing, 
Calgary General Hospital, Calgary, Al 
berta. 

Recognizing, firstly, that the word geriatrics 
is that "branch of medical and nursing 
science that deals with the treatment and 
care of disease conditions in older people, 
including constructive health practice and 
prevention of disease," and formulating, 

FEBRUARY 1967 



secondly, a philosophy or concept of 
geriatrics in keeping with this old age 
can be satisfying and need not be a period 
of idle sitting and waiting for the inevitable, 
death the authors have organized the 
fourth edition of Geriatric Nursing into four 
major units. These include an introduction 
to the aged, and a description of health 
maintenance and illness prevention, the gen 
eral factors in the care of the ill, and clinical 
nursing. 

Unit one emphasizes the attitudes and 
personal qualities essential to the nurse who 
deals with older people. Basic to the nurse s 
approach is a knowledge of the socio-psy- 
chological needs of the aged "the need 
for somewhere to live, something to do, and 
someone to care" and a thorough under 
standing of why these basic needs are 
not met in our society. Related to the prob 
lems of the aged is society s rejection of 
old people and its emphasis on youth and 
beauty. The authors state that the prob 
lem, paradoxically, seems to be one of 
preserving the life of the older person on the 
one hand, while killing him socially on the 
other. 

Unit two discusses maintenance of health 
and prevention of illness. Physical care for 
the aged differs from that for younger per 
sons. Adjustments, small in themselves, may 
mean the difference between the comfort and 
well-being of the older person and his dis 
comfort and predisposition to disease. To 
illustrate, the authors present the adjustments 
necessary for each basic physical need, i.e., 
bathing, skin care, sleep, ventilation, rest, 
activity, posture, clothing, diet, elimination 
and safety; throughout, a general regard for 
the older person is interwoven, emphasizing 
the importance of psychological needs. More 
pictures of older people in their homes, 
rather than in hospital beds, would have 
been useful in this section. 

The authors stress the nurse s strategic 
position in teaching people of the impor 
tance of periodic health appraisals and of 
available community services. Far. too often 
elderly persons and their family members 
interpret nonspecific symptoms as the inevit 
able concomitants of advancing age. 

Unit three, dealing with general factors 
in the care of the ill, discusses housing 
during illness, rehabilitation, and specific 
treatments such as physical and occupational 
therapy. The home is suggested as the best 
place for the elderly patient except in the 
event of acute illness or intensive treatment 
of chronic illness. Home care programs and 
instruction for family members are included 
in the nurse s role. "Repersonalization," or 
the restoration of a sense of personal worth, 



must preceed successful rehabilitation. 

The final unit, more than half of the 
entire book, deals with nursing the elder 
ly persoiv with diseases and is arranged 
according to body systems. Since the clinical 
approach to many of the disease conditions 
is the same for the elderly as for the 
younger person, this book specifically men 
tions only those that pertain to the care of 
the older person. 

This book would be a valuable reference 
book in any school of nursing library be 
cause of its detailed, thoughtful, and in 
dividualized approach to the care of older 
people in our society. 

Psychiatry for Nurses by John Gibson, 
M.D., D.P.M. 156 pages. Oxford, Black- 
well Scientific Publications, 1966. 

Reviewed by Mrs. Doris DesMarteau, 
acting assistant director of nursing, The 
Ontario Hospital, Cobourg, Ontario. 

This book introduces the general duty 
nurse to psychiatry. A welcome addition to 
the works on this subject, it would be a 
useful teaching manual and handy reference 
for all mental health workers. A lucid and 
concise account of the psychiatry of child 
hood to old age, it presents a simplified ap 
proach to a complex subject. 

In her association with the psychiatrist, 
the nurse will constantly hear technical 
terms. If she is familiar with them, she can 
communicate more intelligently with 
members of associated professions, and read 
psychiatric literature with increased under 
standing. With a knowledge of certain group 
ings of personality disturbances, she will 
have a broader insight into the nature of 
her patient s illness. 

In the introduction the author deals with 
the scope of psychiatry. He points out that 
there is no clear distinction between mental 
and physical illness, and that many physical 
diseases manifest themselves through mental 
symptoms. Mentally ill patients, like the 
physically ill, suffer from definite illnesses 
that require individual methods of treat 
ment. 

Chapter two outlines the signs and symp 
toms of mental illness. Subsequent chapters 
deal with neuroses and psychosomatic dis 
orders. Schizophrenia and paranoia are 
considered in detail as two of the most im 
portant psychoses. Alcoholism and drug ad 
diction are explained as social as well as 
medical problems. One chapter describes 
organic diseases that commonly produce 
mental symptoms. 

Chapter fourteen defines mental subnor- 
mality as a common condition. Mental 

THE CANADIAN NURSE 51 



books 



defectives, a large part of any mental hos 
pital s population, demand their own treat 
ment and training that must be understood 
by the nurse. 

In the section devoted to psychiatry of 
childhood, the author emphasizes the prob 
lems presented by mentally ill children, 
which usually differ in certain respects from 
psychiatric problems of adults. 

In his last chapter "Principles of Treat 
ment", Dr. Gibson describes at length treat 
ments and medications applied to many types 
of illnesses. He also mentions some qualities 
essential for the nurse who cares for mental 
patients. 

Knowledge alone does not necessarily 
make it easier to tolerate the persistent hos 
tility, rejection, and discouragement that the 
nurse often meets, but it does help her to 
understand the sufferings of the mentally 
ill that can be deep and tragic. 

The Human Body, A Survey of 
Structure and Function by John 
Cairney, C.M.G., D.Sc., M.D., F.R.A.C.S. 
and J. Cairney, B.Sc., M.B., Ch.B., 
M.C.R.A. 286 pages. Christchurch, New 
Zealand, N.M. Peryer Limited, 1966. 
Reviewed by Miss Jean W. Spalding, 
associate director of nursing education, 
Toronto East General & Orthopaedic 
Hospital. 

This text is written in a clear, concise 
form that would be most helpful in an intro 
ductory course in anatomy and physiology 
for students, who need general information 
and clarification of terminology. The dia 
grams are excellent and adequately labeled, 
providing good visual aids. 

Chapters one to eleven provide the best 
content; later chapters, including those on 
the muscular, nervous, blood vasular, and 
endocrine systems, provide insufficient in 
formation. 

To understand body alignment, passive 
exercises, etc., the nurse must have a 
thorough knowledge of the muscular systems, 
which this book does not provide. More 
over, the chapter on the blood vasular sys 
tem presents insufficient physiologic detail 
and the chapter on the endocrine system 
lacks current information. 

The anatomy in this text would be ade 
quate but sufficient physiology is lacking. 
The major reason for teaching anatomy and 
physiology is to provide a basis for under 
standing health and for providing nursing 
care. This text does not include the material 
necessary to give the student such a back 
ground. Its value would be enhanced by the 
addition of questions at the end of each 
chapter for review and application, and a 
bibliography for reference. 
52 THE CANADIAN NURSE 




a show of hands... 





\ 



proves its smoothness 



NEW FORMULA ALCOJEL, with 
added lubricant and emollient, will 
not dry out the patient s skin 
or yours! 

ALCOJEL is the economical, modern, 
jelly form of rubbing alcohol. When 
applied to the skin, its slow flow 
ensures that it will not run off, drip 
or evaporate. You have ample time 
to control and spread it. 

ALCOJEL cools by evaporation . . . 
cleans, disinfects and firms the skin. 

Your patients will enjoy the 
invigorating effect of a body rub with 
Alcojel . . . the topical tonic. 




ALCOJEL 

Send for a free sample 

through your hospital pharmacist. 



Jellied 

RUBBING 



WITH 

ADDED 
LUBRICANT an^ 





THE BRITISH DRUG HOUSES (CANADA) LTD. 

Barclay Ave., Toronto 18, Ontario 



FEBRUARY 1967 



books 



Rehabilitative Aspects of Nursing, A 
Programed Instruction Series. Part 1. 
Physical Therapeutic Nursing Measures. 
Unit 1. Concepts and Goals. 51 pages. 
New York. National League for Nursing, 
1966. 

This programed unit is the first of a 



series of programed nursing texts planned 
by the National League for Nursing. It 
was prepared especially for inservice edu 
cation of nursing staff and for self-instruc 
tion by individual nurses. It is designed to 
enable nurses to learn, at their own speed, 
new facts and skills in rehabilitative nursing. 

This introductory unit is devoted to gen 
eral concepts and goals and to the treatment 
of the patient as a whole person. Future 
books will deal with range of joint motion, 
muscle conditioning, body positioning, and 
assessment processes in rehabilitative nursing. 

The booklet is easy to use and thoroughly 






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of cross contamination after use. 

Contains everything nteded for Surgical Prps: 



Non-Clogging Razor with Gillette s 
New Double Edge Super Stainless Steel 
Blade assembled and ready to use. 

Sponge Impregnated with Hexachloro- 
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EP-105 Same contents as EP-109 but with 
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PK-104 Same contents as EP-105 but with 
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FEBRUARY 1967 



As with oil sterile disposable items, the packaging 
should always be checked, tf the packaging is 
damaged or the seal is broken the product should 
not be considered sterile. 

OF CANADA, LTD. 836 RANGEVIEW ROAD 
PORT CREDIT, ONTARIO, CANADA 



covers the introductory aspects of rehabilita 
tive nursing. The time required to complete 
all frames is approximately two and one- 
half hours. 

Much of the material is extremely simple 
and would appear to be more valuable to 
students than to graduate nurses. However, 
considerable attention is given to aspects of 
care that involve diagnosis, assessment, and 
establishment of physical therapeutic nursing 
measures on the nurse s own initiative, that 
is, in her own team role and without the 
supervision of other disciplines. 

The book would be a useful addition to 
any ward library. Inservice nursing educators 
would find it valuable as a supplement and 
adjunct to many teaching programs. 

History and Trends of Practical Nurs 
ing by Dorothy F. Johnston, R.N., B.S., 
C.P.H.N., M.Ed. 171 pages. Saint Louis, 
Mosby, 1966. 

Reviewed by Mrs. P. Ecclestone, acting 
instructor, School for Nursing Assistants, 
King Edward Vll Memorial Hospital, 
Bermuda. 

This interesting book outlines the events 
that have shaped and brought into existence 
the present-day practical nurse or nursing 
assistant, as she is known in Canada. Five 
of the nine chapters deal with the past, two 
with the present, and one with the future 
of this auxiliary worker. 

The author traces the development of 
the practical nurse from the primitive 
woman who remained at home caring for 
the weak and sick while man foraged for 
food, through the religious orders, which 
provided rituals and housekeeping services 
rather than actual nursing care, to the 
beginning of the training of lay women in 
the early nineteenth century. 

In discussing the early training programs 
and the growth and expansion of the profes 
sion, the author gets rather bogged down 
in dates and details. The reviewer found 
herself flipping pages and reading the con 
cise and comprehensive summaries at the 
end of each chapter. 

In the chapter "War and Awakening," 
the author describes the professional nurse s 
realization, after World War II, of the need 
for the practical nurse in the hospital as 
well as in the home. The professional nurse 
finally accepted the responsibility for her 
control. Many states began passing laws for 
her licensure, curricula were expanded, her 
title was standardized, and she emerged a 
recognized and necessary part of the health 
team. 

The author discusses todays practical 
nurse in the United States and nursing 
assistants in Canada in chapters 7 and 8. 
Canadian nurses will find Chapter 8 very 
interesting, as the author describes the 
number of schools, admission requirements, 

THE CANADIAN NURSE 53 



books 



length and description of the course, and 
number of trained assistants employed in 
each province. 

In her final chapter, "Preview of the 
Future," Miss Johnston discusses the areas 
in which the practical nurse is now em 
ployed, and conjectures about her future. 
In spite of rumblings in some camps to the 
effect that the practical nurse faces ex 



tinction with the emergence of a "new 
nurse" who is a product of a two to three- 
year course in an independent school, the 
author believes that the outlook for the 
practical nurse is excellent, as thousands 
more are needed for employment in general 
hospitals, psychiatric hospitals, health agen 
cies, geriatric hospitals, doctors offices, and 
even by the Peace Corps. 

In general, this is a well-written, thorough 
ly researched text, and would be useful for 
instructors of nursing assistants or practical 
nurses, students themselves, and, in part, 
to professional nursing students and their 
instructors. 



TO PLAN FOR A LIFETIME 






\ 





Marriage is a responsibility that often re 
quires both spiritual and medical assistance 



Nurses are invited to use the coupon below 
to order copies for use as an aid in coun 



from professional people. In many instances selling. They will be supplied by Mead John- 



a nurse may be called upon for medical 
counsel for the newly married young wo 
man, mother, or a mature woman. 

"To Plan For A Lifetime, Plan With Your Doc 
tor" is a pamphlet that was written to assist 
in preparing a woman for patient-physician 
discussion of family planning methods. The 
booklet stresses the importance to the indi 
vidual of selecting the method that most 
suits her religious, medical, and psychological 
needs. 



son Laboratories as a free service. 




LABORATORIES 



"1 



ORDER FORM To: Mead Johnson Laboratories, 

111 St. Clair Avenue West, 
Toronto 7, Ontario. 

Pleat* lend copies of "To Plan For A Lifetime, Plan Wilh Your 

Doctor" to: 

Name 

Address 



\_-_-_ 

^^_ __ . _ _. . ._ 

54 THE CANADIAN NURSE 



films 



History of Medicine 

The Canadian Medical Association has 
prepared a special film for Canada s Cen 
tennial year. A Century of Canadian Medicine 
(28-minute, color, sound) depicts the pro 
gress of medicine over the past 100 years. 

The film demonstrates the profession s 
commitment to the improvement of the 
nation s health. The life-and-death gambles 
with diseases such as pneumonia or tuber 
culosis in 1867 have changed to scenes 
where medication and treatment can over 
come the infection, and life goes on with 
little interruption. Recent advances in med 
icine and surgery have been selected to 
show lay audiences some of the results of 
medical progress, such as open-heart sur 
gery, care of premature babies, and the 
use of physiological monitors. 

As a secondary objective, it is hoped that 
the film will stimulate recruitment of 
young people interested in and capable of 
carrying on the traditions of service and 
science. 

This centennial film would be of inter 
est to nurses -- especially useful in his 
tory courses and as a film to recommend 
for showings to high school students. For 
information concerning its use, write to 
The Secretary, Public Relations, Canadian 
Medical Association, 150 St. George Street, 
Toronto 5, Ontario. 



Through the Eyes of the Patient 

An unusual and excellent teaching film, 
Candidate for a Stroke, has recently been 
added to the lists of films available from 
the Canadian Heart Foundation. In this 
film the audience sees the world as through 
the eyes of a man having a mild stroke. 
Diagnosis, treatment, and rehabilitation are 
all seen as though the audience was the 
patient. The film also concludes with the 
steps necessary to reduce the risk factors 
that lead to a cerebrovascular accident. 

This 18-minute, black-and-white, sound 
film would be valuable as a teaching aid 
in medical-surgical nursing. It may be 
borrowed from the Canadian Heart Found 
ation, 1130 Bay St., Toronto 5, Ontario. 

Dangers of Superficial Relationships 
The Special Universe of Walter Krolik, 

a new, 28-minute, color, sound film, pre 
sents a patient-family story. The film was 
intended primarily for a nursing audience 
and is not suitable for a lay group. It dis 
cusses the outcome of nurse-patient relation 
ships when a response is made to super 
ficial needs without an assessment of un 
derlying needs. In this film, nurses appear 

FEBRUARY 1967 



films 



to be winning the battles and losing the 
war. 

The film would be an excellent teaching 
tool in schools of nursing, or in continuing 
education programs for graduates. It is 
directly concerned with the patient with 
tuberculosis, but many of the concepts 
are applicable to any chronic or continuing 
patient care. 

The film was prepared in the United 
States and was co-sponsored by the Na 
tional Tuberculosis Association, the Nur 
sing Advisory Service on Tuberculosis and 
Other Respiratory Diseases, and the ANA- 
NLN Film Service. It was made possible by 
a grant from the American Contract Bridge 
League Foundation. It may be borrowed 
from your local branch of the Canadian 
Tuberculosis Association. 

Excellent for Adolescents 

An excellent motion picture on growth 
and development for adolescent and teen 
age girls has been produced by Churchill 
Films. Girl to Woman is a scientific and 
authoritative treatment of the sensitive 
subject of puberty, and is produced under 
medical and psychiatric supervision. Ex 
tensive animation is used to show the 
female reproductive system and the tur- 



Nursing Studies Index 

A revision of the Canadian 
Nurses Association Nursing Studies 
Index, first issued in 1964, is in 
preparation. If you know of any 
studies, i.e., masters and doctoral 
theses and studies by government 
organizations and institutions, 
which have been completed be 
tween 1964 and 1966, or any prior 
to 1964 that were missed in the 
first issue, please notify the Libra 
rian, Canadian Nurses Association, 
50 The Driveway, Ottawa. The 
only criteria is that the study be on 
some aspect of concern to nursing 
in Canada, or, in the case of theses, 
be conducted by a Canadian nurse. 

Also, the Library is hoping to have 
as many copies as possible of the 
studies listed in the index in the 
CNA repository collection of nurs 
ing studies. If you have only one 
copy of your study, please lend 
it to us with permission to xerox. 



bulent changes that take place during and 
after puberty. 

The film is a companion to Boy To Man, 
released a few years ago, which has re 
mained the most authoritative film in its 
field. It would be valuable for use in schools 
as well as a teaching tool for nurses. 

The film is in color, and runs 16 minutes. 
It may be borrowed from the Canadian 
Film Institute, 1762 Carling Ave., Ot 
tawa 13. A small rental fee is charged. 



accession list 



Publications in this list of material re 
ceived recently in the CNA library are 
shown in language of source. The majority 
(reference material and theses, indicated by 
R, excepted) may be borrowed by CNA 
members, and by libraries of hospitals and 
schools of nursing and other institutions. 
Requests for loans should be made on the 
"Request Form for Accession List" (page 
57) and should be addressed to: The Li 
brary, Canadian Nurses Association, 50 
The Driveway, Ottawa 4, Ontario. 

BOOKS AND DOCUMENTS 

1. L automalion par Louis Salleron. 4. ed. 
Paris, Presses Universitaires de France, 
1965. 125p. (Que sais-je? no. 723.) 



2. Canadian annual review for 1965. 
Edited by John Saywell. Toronto, Univ. of 
Toronto Press, 1966. 569p. 

3. Canadian universities and colleges 1966. 
ed. by Edward Sheffield and Rosalind J. 
Murray. Ottawa, Association of Universities 
and Colleges, 1966. 335p. 

4. Communication and public relations 
by Edward J. Robinson. Columbus, Ohio, 
Charles E. Merril Books, c!966. 618p. 

5. Continuing professional educational 
needs of supervisory personnel in the nursing 
service and nursing education; a survey of 
Pennsylvania hospitals by Sammuel S. Du- 
bin and H. LeRoy Marlow. University Park, 
Perm., Pennsylvania State Univ., 1965. 65p. 

6. La cybernetique par Louis Couffignal. 
Paris, Presses Universitaires de France, 1963. 
125p. (Que sais-je? no. 638.) 

7. The determination and measurement of 
supervisory training needs of hospital per 
sonnel; a survey of Pennsylvania hospitals 
by Samuel S. Dubin and H. LeRoy Marlow. 
University Park, Penn., Pennsylvania State 
Univ., 1965. 132p. 

8. Documents fondamentaux; statuts et 
reglement directives reglements interieur 
pour les seances par Conseil International 
des Infirmieres. London, 1966. 47p. 

9. Dotation en personnel des services in- 
firmiers de sante publique et de soins aux 
malades non hospitalises. Methodes d etude, 
par Doris E. Roberts. Geneve, Organisation 
mondiale de la Sante. 1965. Hip. 




ostqmy 

anatomical 

demonstrator 



"MINI-GUIDE" 



"Mini-Guide" allows you to visually and 
graphically perform Colostomy, Ileostomy Ileal- 
Bladder, Wet Colostomy and Cutaneous Ureterostomy 
surgery. 

As an instructor, you are afforded a simple, effective method of teaching the surgical 
mechanics and organs involved in ostomy surgery; as a student, you immediately see 
and understand the procedures of ostomy surgery; and as a nurse, you have the per 
fect vehicle for visual demonstrations to the patient who is to undergo ostomy surgery. 
The "Mini-Guide" anatomical demonstrator is priced at $1.00 on this money-back 
offer 746 CN. 



NITED SURGICAL 




I P O R A 

PORT CHESTER NEW YORK 



FEBRUARY 1967 



THE CANADIAN NURSE 55 



Next Month 
in 

The 

Canadian 
Nurse 



Nursing 
in the 
north 



Changes 
in nursing 
education in 
Saskatchewan 



RN employed 
at a 

veterinary 
college 




Photo credits 



Expo 67, p. 7 

Globe and Mail, p. 13 

USSR Embassy, pp. 27, 29, 32 

Dept. of National Health and 
Welfare, p. 42 



accession list 



10. L equilibri- sympalhique par Paul 
Chauchard. Paris, Presses Universitaires de 
France, 1961. 128p. (Que sais-je? no. 565.) 

11. Factors affecting the establishment of 
associate degree programs in nursing in 
community junior colleges by Mildred S. 
Schmidt. New York, National League for 
Nursing, 1966. 128p. 

12. Final report on draft legislation pre 
pared for the New Brunswick Association 
of Registered Nurses by Alan M. Sinclair. 
Fredericton, 1 966. 1 v. 

13. Governments and the university by 
York University, Toronto, MacMillan, 1966. 
92 p. (The Frank Gerstein lectures, 1966). 

14. L heredite humaine par Jean Ros 
tand. 6.ed. Paris, Presses Universitaires de 
France, 1965. 126p. (Que sais-je? no.550.) 

15. History of the school for nurses To 
ronto General Hospital by Margaret Isabel 
Lawrence (ed). Toronto, Alumni Associa 
tion, 1931. 63p. 

16. Nursing studies index, vol. 3, 1950- 
1956 prepared under Virginia Henderson. 
Philadelphia, Lippincott, 1966. 653p. R 

17. La profession d infirmiere en France, 
2ed. par Revue de 1 Infirmiere et de 1 As- 
sistante Sociale. Paris, Expansion Scienti- 
fique francais, 1962. 377p. 

18. Report on action prepared for the 
New Brunswick Association of Registered 
Nurses by Katherine MacLaggan. Frederic- 
ton, 1966. 63 p. 

19. Le role de I infirmiere dans faction 
de sante mentale; rapport sur une confe 
rence technique, Copenhague, 15-24, no- 
vembre 1961 par Audrey L. John et al. 
Geneve, Organisation mondiale de la Sante, 
1965. 214p. 

20. A series of papers presented at the 
1965 regional clinical conferences sponsored 
by the American Nurses Association, New 
York, 1966. 6v. Contents. 1. Nursing 
practice. 2. Medical-surgical nursing prac 
tice. 3. Maternal and child health nursing 
practice. 4. Psychiatric nursing practice. 
5. Public health nursing practice. 6. 
Geriatric nursing practice. 

21. Les services infirmiers de sante pu- 
blique; problemes et perspectives par Or 
ganisation mondiale de la Sante. Geneve, 
1961. 208p. 

22. The sister as a clinical specialist by 
Sister Leon Douville and Sister Marilyn 
Emminger. St. Louis, Conference of Catho 
lic Schools of Nursing, 1966. 126p. 

23. A survey to determine the nursing 
care needs of patients in certain standard 
welfare wards (indigent) of the Ottawa Civic 
Hospial following their discharge from the 
hospital by Muriel V. Lowry. Ottawa, 1962. 
Sip. 

24. Le systeme nerveux par Paul Chau 
chard. lO.ed. Paris, Presses Universitaires de 
France, 1966. 128p. (Que sais-je? no. 8.) 



56 THE CANADIAN NURSE 



25. Les tesles mentaux par Pierre Pichot. 
Paris, Presses Universitaires de France, 

1965. 126p. (Que sais-je? no. 626.) 

PAMPHLETS 

26. Book and journal services for doctors 
and nurses. An interim report on a National 
Book League investigation by J.E. Mor- 
purgo. London, Nuffield Provincial Hospi 
tals Trust. 1966. 41 p. 

27. A brief to the select committee of the 
New Brunswick legislature on the labour 
relations act. Fredericton, New Brunswick 
Association of Registered Nurses, 1966. 

28. Directory of Canadians with service 
overseas, 1966. Ottawa, Overseas Institute 
of Canada, 1966. 478p. 

29. A guide for the nursing service audit 
by Sister Mary Helen Louise Deekin. St. 
Louis, Catholic Hospital Association, 1960. 
26p. 

30. A guide for the utilization of per 
sonnel supportive of public health nursing 
services. New York, American Nurses As 
sociation, Public Health Nurses Section, 

1966. 12p. 

31. Guiding principles for the develop 
ment of programs in educational institutions 
leading to a diploma in nursing. Ottawa, 
Canadian Nurses Association, 1966. lip. 

32. An index of care by J.A.K. MacDon- 
nell and G.B. Murray. Ottawa, Medical 
Services J. 31:499-517, Sep. 1965. Reprint. 

33. Major official policies relating to the 
economic security program. Rev. New York, 
American Nurses Association, 1965. 14p. 

34. NLN accreditation-community nursing 
services; guide to preparing a report for 
evaluation for preliminary accreditation. 
New York, National League for Nursing. 
Department of Public Health Nursing, 1966. 
9p. 

35. The planning and organization of 
medical book and journal services in region 
al hospitals. A National Book League guide 
for librarians. London, Nuffield Provincial 
Hospitals Trust, 1966. 34p. 

36. Principes directeurs de la mise au 
point de programmes dans les maisons d en- 
seignement, en vue de diplome en sciences 
infirmieres. Ottawa, Association des Infir 
mieres canadiennes, 1966. 12p. 

37. Recommendation from the Associa 
tion of Nurses of Prince Edward Island re 
garding medical procedures carried out by 
nurses. Fredericton, n.d. 2p. 

38. Seeking foundation funds by David 
M. Church. New York, National Public 
Relations Council of Health and Welfare 
Services, Inc., c!966. 39p. 

39. Statement relative to the national 
labor-management relations act, 1947, May 
7, 1963. New York, American Nurses As 
sociation, 1963. lOp. 

40. Statistical data associate degree pro 
grams in nursing 1966. New York, National 
League for Nursing. Dept. of Associate De 
gree Programs, 1966, 8p. 

41. Suggested design guidelines for nur- 

FEBRUARY 1967 



accession list 



sing education facilities; schools of nursing. 
Toronto, Ontario Hospital Services Com 
mission, 1966. 5p. 

42. Survey of employment conditions of 
nurses employed by physicians and for 
dentists, July 1964. New York, American 
Nurses Association. Research and Statistics 
Unit, 1965. 24p. 

GOVERNMENT DOCUMENTS 

Canada 

43. Dept. of Labour. Labour-Management 
Co-operation Service. Labour management 
Committee material, order book. Ottawa, 
Queen s Printer, 1966. 30p. 

44. Dominion Bureau of Statistics. Census 
of Canada 1961. General review. Housing 
in Canada. Ottawa, Queen s Priner, 1966. 
79p. 

45. Parliament. House of Commons. Bill 
C-170; an act respecting employer and em 
ployee relations in the Public Service of 
Canada. Ottawa, 1966. 53p. 

Nova Scotia 

46. Dept. of Labour. Economics and Re 
search Division. Wage rates and hours of 
labour in Nova Scotia. Halifax, 1966, 226p. 
United States 

47. Dept. of Health, Education and Wel 



fare. Public Health Service. Administrative 
aspects of hospital central medical and surg 
ical supply services. Washington, 1966. 37p. 

48. Dept. of Health, Education and Wel 
fare. Public Health Service. Estimating the 
cost of illness by Dorothy P. Rice. Washing 
ton, 1966. 131p. 

49. Dept. of Health, Education and Wel 
fare. Public Health Service. A manual for 
hospital central medical and surgical supply 
services. Washington, 1966. 106p. 

50. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree 
ments; arbitration procedures. Washington. 
U.S. Govt. Print. Off., 1966. 167p. 

51. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree 
ments; management rights and union- 
management co-operation. Washington, U.S. 
Govt. Print. Off., 1966. 69p. 

52. Dept. of Labour. Women s Bureau. 
Handbook on women workers 1960. Wa 
shington, U.S. Govt. Print. Off., 1960. Iv. 

53. Dept. of Labour. Women s Bureau. 
Nurses and other hospital personnel; their 
earnings and employment conditions. Re 
printed with supplement. Washington, U.S. 
Govt. Print. Off., 1961. 41p. 

STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION. 

54. An enquiry into the need for conti 
nuing education for registered nurses in 
the province of Ontario by M. Josephine 
Flaherty. Toronto, 1965. 176p. Thesis (M. 



A.) Toronto. R 

55. The historical development of one 
aspect of curriculum development in nursing 
education by Sister Marie Bonin. Washing 
ton, 1965. Thesis (M.Sc.N.) -- 1965. R 

56. Methods of evaluating the service of 
professional nursing students in selected 
schools of nursing by Margaret Mary Street, 
Boston, 1961. 105p. Thesis (M.Sc.N.) - 
Boston. R 

57. The preparation of survey schedules 
for the selection of the facilities in three 
Canadian provinces for the organization of 
a collegiate program in nursing by Sister 
Jeanne Forest. Washington, 1945. Thesis 
(M.Sc.N.Ed.) Catholic Univ. of America. 
108p. R 

58. Relationship between achievement in 
high school and achievement on the exa 
minations for admission to practice nursing 
in Canada by Sister Claire Jeannotte. Wash 
ington, 1965. Thesis (M.Sc.N.) Catholic 
Univ. of America. 44p. R 

59. A study of the educational value of 
a learning experience in a rural hospital 
setting by Sister Marguerite Letourneau. 
Washington, 1963. Thesis (M.Sc.N.) 
Catholic Univ. of America. 89 p. R 

60. A study of performance on pre-en- 
trance tests and examinations for admission 
to practice and the relationship between 
these tests by Sister Jeannette Gagnon. 
Washington, 1963. Thesis (M.A.) Catho 
lic Univ. of America. 54p. R 




Turns 

consume 

93 times their 

own weight 

in excess 

stomach 

acid! 



think how last they ll work 
on your tummy upsets! 

FEBRUARY 1967 



Laboratory tests show Turns neu 
tralize 93 times their own weight 
in excess stomach acids, and that 
they maintain a balanced level for 
long periods, too. Turns go to work 
in 4 seconds on gas, heartburn and 
indigestion. And they taste pleas 
antly minty, need no water and 
cost so very little. Those are the 
facts. So next time your tummy 
gives you a turn, give Turns a try. 
They re worth their weight in gold! 




Request Form 
for "Accession List" 

CANADIAN NURSES- 
ASSOCIATION LIBRARY 

Send to: 

LIBRARIAN, Canadian Nurses Association, 

50 The Driveway, Ottawa 4, Ontario. 

Please lend me the following publications, listed in the 

issue of The Canadian Nurse, 

or add my name to the waiting list to receive them when 
available. 



Item 
No. 



Author Short title (for identification) 



Request for loans will be filled in order of receipt. 
Reference and restricted material must be used in the 
CNA library. 
Borrower 



Position 



Address 

Date requested 



THE CANADIAN NURSE 57 



classified advertisements 



ALBERTA 



ALBERTA 



BRITISH COLUMBIA 



NIGHT SUPERVISOR, R.N. AND MEDICAL HEAD 
NURSE for 90-bed active treatment hospital in the 
City of Wetaskiwin, situated midway between Ed 
monton and Red Deer. Residence accommodation 
available, excellent salary ranges and fringe benefits 
in effect, as well as payment for prior experience. 
Apply to: Director of Nursing, Municipal Hospital, 
Wetaskiwin, Alberta. 1-96-1 

Registered Nurses for new 50-bed active treatment 
hospital, situated only 15 miles from Edmonton. 
Salary $360 - $420 per month. Recognition given for 
previous experience. Excellent personnel policies and 
working conditions. For further information please 
write to: Miss M. Macintosh, R.N., Director of 
Nursing, Fort Saskatchewan General Hospital, Box 
1270, Fort Saskatchewan, Alberta. 1-39-2 

Registered Nurses (5) required (summer relief or per 
manent posts) for May 1967. The Peace River Municipal 
Hospital, Alberta, was built 5 years ago and has a 
complement of 70 beds. Starting salary for 1 966 
$370. New salary scales expected for 1967. Peace 
River is a progressive town and a beauty spot on the 
Prairies. Apply to: The Director of Nursing for fuller 
particulars. Peace River , Municipal Hospital, Peace 
River, Alberta. 1-69-1 

Registered Nurses and Certified Nursing Aides for 

17-bed hospital. Salary for Graduate Nurses basic 
$400 to $460. Certified Nursing Aides $240 to $280 
with credit for previoue experience. Full maintenance 
available at $35 per month. Apply to: Miss A. Nun- 
weiler, Director of Nursing, Oyen Municipal Hospital, 
Oyen, Alberta. Telephone: 664-3553 1-68-1 

General Duty Nurses (2) for a modern general 30- 
bed hospital. East Central Alberta Highway 12. 
Salary according to experience, yearly increments. 
AARN personnel policies. Apply to: Sister Adminis 
trator, Our Lady of the Rosary Hospital, Castor, 
Alberta. 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$10.00 for 6 lines or less 
$2.00 for each additional line 

Rates for display 
advertisements on request 

Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 

The Canadian Nurses Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses Association of the 
Province in which they are interested 
in working. 



Address correspondence to: 

The 

Canadian 
Nurse 




50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 



REGISTERED NURSES FOR GENERAL DUTY (WANTED) 

for a 37-bed General Hospital. Salary $380 - $440 
per month. Commencing with $375 with J year and 
$390 wiih 3 years practical experience elsewhere. 
Full maintenance available at $35 per month. Pen 
sion plan available, train fare from any point in 
Canada will be refunded after I year employment. 
Hospital located in a town of 1 ,100 population, 85 
miles from Capital City on a paved highway. 
Apply to: Two Hills Municipal Hospital, Two Hills, 
Alberta. 1-88-1 

NURSES FOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hat. 
Nurses on staff must be willing and able to take re 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses residence with all single rooms situated on 
hospital grounds. Apply to: Mrs. M. Hislop, Adminis 
trator and Director of Nursing, Bassano General Hos 
pital, Bassano, Alberta. 1 -5-1 

General Duty Nurses for an active accredited well 
equipped 64- bed hospital in a growing town, popu 
lation 3,500. Centrally located between major cities. 
Full maintenance available in a new residence, $35.00 
per month. Alberta Registered Nurses salary $360.00 
- $420.00, commensurate with experience. Excellent 
personnel policies and working conditions. Apply: 
Director of Nursing, Brooks General Hospital, Brooks, 
Alberta. 1-13-1 A 

GENERAL DUTY NURSES for modern 25-bed hos 
pital on Highway No. 12, East-Central Alberta. 
Salary range $380 to $440. (including a regional 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronation Municipal Hospital, 
Coronation, Alberta. Tel-: 578-3803. 1-25-1B 

GENERAL DUTY NURSES for 64-bed, active treatment 
hospital, 35 miles South of Calgary. Salary range 
$360 - $420. Living accommodation available in 
separate residence if desired. Full maintenance in 
residence $35 per month. 30 days paid vacation after 
12 months employment. Please apply to: The Director 
of Nursing, High River Municipal Hospital, High 
River, Alberta. 1-46-1 

GENERAL DUTY NURSES: Modern 26-bed hospital 
close to Edmonton. 3 buses daily. Salary $360.00 to 
$420.00 per month commensurate with experience. 
Residence available $35.00 per month. Excellent 
personnel policies. Apply: Director of Nursing, 
Mayerthorpe Municipal Hospital, Mayerthorpe, Al 
berta. A1 



GENERAL DUTY NURSES for 94-bed General Hospital 
located in Alberta s unique Dinosaur Badlands. $360 
$420 per month, 40 hour week, 31 days vacation, 
pension, Blue Cross, M.S.I, and generous sick time. 
Apply to: Miss M. Hawkes, Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberta. 1-31-2 A 

General Duty Nurses and Certified Nursing Aides for 

modern combined active treatment and Auxiliary 
Hospital. Salary starts at $355 and $240 respectively. 
Liberal personnel policies, accommodation available. 
Located in Southern Alberta close to U. S. boundary 
and Waterton-Glacier International Peace Park. The 
61 -bed combined hospital serves the town and area of 
approximately 6,000 population with all services. 
Apply to: The Director of Nursing, Cardston Municipal 
Hospital, Box 310, Cardston, Alberta. 1-17-1 

GENERAL DUTY NURSES (6) and CERTIFIED NURS 
ING AIDES for modern 72-bed hospital. Salary $355 
and $240 respectively; credit for experience; liberal 
policies. Accommodation available. Apply to: Ad 
ministrator, Providence Hospital, High Prairie, Al 
berta. 1-45-1 



B.C. R.N. for General Duty in 32 bed General Hospi 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefits, modern, comfortable, nurses residence in 
attractive community close to Vancouver, B.C. For 
application form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. 1, Hope, B.C. o in t 



BRITISH COLUMBIA 



Operating Room Hoad Nurse ($464 - $552), General 
Duty Nurses (B.C. Registered $405 - $481, non-Regis 
tered $390) for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, curling 
and bowling. Hot springs swimming nearby. Nurses 
residence, room $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36-1 

Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Registered Nurses (or those eligible) to apply for 
positions in Medicine, Surgery and Psychiatry. Apply 
to : Director of Nursing. Victoria, British Columbia. 

2-76-4A 



2-30-1 



GENERAL DUTY NURSES (Two) for active 66-bed 

hospital, with new hospital to open in 1968, 
Active in-service programme. Salary range $372 to 
$444 per month. Personnel policies according to 
current RNABC contract. Hospital situated in beauti 
ful East Kootenays of British Columbia, with swim 
ming, golfing and skiing facilities readily available. 
Apply to; The Director of Nursing, St. Eugene Hos 
pital, Cranbrook, British Columbia. 2- 15-) 




General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in accordance with RNABC. Com 
fortable Nurses home. Apply: Director of Nursing, 
Boundary Hospital, Grand Forks, British Columbia. 

2-27-2 



General Duty Nurses (2 immediately) for active, 
26-bed hospital in the heart of the Rocky Mountains, 
90 miles from Banff and Lake Louise. Accommoda 
tion available in attractive nurses residence. Apply 
giving full details of training, experience, etc. to: 
Administrator, Windermere District Hospital, Inver- 
mere, British Columbia. 2-31-1 



General Duty Nurses for new 37-bed hospital. 
Located in Southwest British Columbia. Salary and 
personnel policies in accordance with RNABC. $390 
to $466. Accommodation available in residence. Apply 
to: Director of Nursing, Nicola Valley General Hos 
pital, Box 129, Merritr, British Columbia. 2-41-1 

General Duty Nurses for well-equipped 80-bed Gener 
al Hospital in beautiful inland Valley adjacent Lake 
Kathlyn and Hudson Bay Glacier. Initial salary $387. 
Maintenance $60, 40-hour 5 day week, vacation with 
pay, comfortable, attractive nurses residence, 
floating, fishing, swimming, golfing, curl ing, skating, 
skiing. Apply to: Director of Nursing, Bulkley Valley 
District Hospital, P.O. Box No. 370, Smithers, British 
Columbia. 2-67-1 

GENERAL DUTY NURSES Salary non B.C. 

registered $375 per month B.C. registered $390 
$466, depending on experience. RNABC policies 
effect. Nurses residence available. Group Medical 
Health Plan. All winter and summer sports. Apply: 
Director of Nursing, Cariboo Memorial Hospital, Wil 
liams Lake, British Columbia. 2-80-1 A 



General Duty O. R. and experienced Obstetrical 
Nurses for modern, 1 50-bed hospital located in the 
beautiful Fraser Valley. Personnel policies in ac 
cordance with RNABC. Apply to: Director of Nursing, 
Chilliwack General Hospital, Chilliwack, British Co 
lumbia. 2-13-1 

General Duty and Operating Room Nurses for 70-bed 

Acute General Hospital on Pacific Coast. B.C. Regis 
tered $390 - $466 per month (Credit for experience). 
Non B.C. Registered $375 Practical Nurses B.C. Li 
censed $273 -$311 per month. Non Registered $253- 
$286 per month. Board $20 per month, room $5.00 per 
month. 20 paid holidays per year and 10 statutory 
holidays after 1 year. Fare paid from Vancouver. 
Superannuation and medical plans. Apply: Director of 
Nursing, St. George s Hospital, Albert Bay, British 
Columbia. oo i a. 



58 THE CANADIAN NURSE 



General Duty, Operating Room and Experienced 
Obstetrical Nurses for 434-bed hospital with school 
of nursing. Salary: $372-$444. Credit for past ex 
perience and postgraduate training. 40-hr, wk. Stat 
utory holidays. Annual increments; cumulative sick 
leave; pension plan; 28-day $ annual vacation; B.C. 
registration required. Apply: Director of Nursing, 
Royal Columbian Hospital, New Westminster, British 
Columbia. 2-73-13 

Graduate Nurses for 31-bed hospital on B.C. Coast 
Salary $372 for B. C Registered Nurses plus $lf 
northern living allowance. Personnel policies in 
accordance with RNABC. Travel from Vancouver 
refunded after 6 mos. Apply: Administrate, General 
Hospital, Ocean Falls, British Columbia. 2-49-1 

GRADUATE NURSES for 24-bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel prac 
tices in accord with RNABC. Accommodation availa 
ble. Apply: Director of Nursing, General Hospital, 
Squamish, British Columbia. 2-68-1 

FEBRUARY 1967 



BRITISH COLUMBIA 



ONTARIO 



ONTARIO 



General Duty and Operating Room Nurses for 

modem 450-bed hospital with School of Nursing. 
RNABC policies in effect. Credit for past experience 
and postgraduate training. British Columbia registra 
tion required. For particulars write to: the Director of 
Nursing Service, St. Joseph s Hospital, Victoria, British 
Columbia. 2-76-5 



GRADUATE NURSES for busy 21-bed general hospital 

preferably with obstetrical experience. Friendly at 
mosphere, beautiful beaches, local curling club. 
Own room and board $40 month. Basic salary $357 
or $372 plus recognition for post graduate ex 
perience. Apply Matron, Tofino General Hospital, 
Tofino, Vancouver Island, B. C. 2-71-1 



MANITOBA 



Director of Nurses for up-to-date 38-bed hospital. 
New nurses residence of 1964 has separate nurses 
suite available. Sick leave, pension plan and other 
fringe benefits available. Personnel policies will be 
sent on request. Enquiries should include experience, 
qualifications and salary expected, and should be 
addressed to: Mr. O. Hamm, Administrator, Altona 
Hospital District No. 24, Box 660, Altona, Manitoba. 

3-1-1 



Registered Nurses (2) for 50-bed General Hospital in 
Fort Churchill, Manitoba, Starting salary $470 per 
month with higher 1967 schedule effective January 1. 
Train fare from Winnipeg refunded after six months 
service, and return fare refunded after one year 
i service. Apply to: Director of Nursing. For 
Churchill General Hospital, Fort Churchill, Mani 
toba. 3-75-1 



Registered Nurses (1) for 10-bed hospital at Fisher 
Branch. Manitoba. Starting salary $400/m. Duties to 
commence as soon as possible. Residence accom 
modation available. For further information and ap 
plication forms, apply to: Matron, Fisher Branch 
Hospital, Fisher Branch, Manitoba. 2-23-2 



Registered Nurse for 18-bed hospital at Vita Manitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
range $380 $440, with allowance for experience. 
40 hour week, 10 statutory holidays, 4 weeks paid 
vacation after one year. Full maintenance available 
for $50 per month. Apply: Matron, Vita District 
Hospital, Vita, Manitoba. 3-68-1 



Registered Nurses and Licensed Practical Nurses for 

232-bed Children s Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: Director of Nursing, Children s Hos 
pital, Winnipeg 3, Manitoba. 3-72-1 

Registered Nurse for General Duty in 20-bed hospital. 
Salary range $380 - $440 per month to be increased 
Jan. 1 , 1967. Room and board available at $55-50 
per month. Generous personnel policies. Full details 
available on request. Apply: Director of Nursing, 
Reston Community Hospital, Reston, Man. 3-46-2 

General Duty Nurses for 100-bed active treatment hos 
pital. Fully accredited. 50 miles from Winnipeg on 
Trans Canada Highway. Apply: Director of Nursing 
Service, Portage District Genera! Hospital, Portage La 
Prairie, Manitoba. 3-45-1 



NOVA SCOTIA 



REGISTERED NURSES for 53-bed medium and long- 
term active treatment hospital in a progressive city. 
Particulars on request. Apply to: Director of Nursing, 
Halifax Civic Hospital, 5938 University Avenue, Hali 
fax, Nova Scotia. 6-17-10 A 



Registered Nurses for 21-bed hospital in pleasant 
community - - Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital, 
Sheet Harbour, Nova Scotia. 6-32-J 



ONTARIO 



Co-ordinafor of Clinical Nursing Studies in the 
Bachelor of Science in Nursing Course: The School 
of Nursing, McMaster University, invites applications 
from persons with advanced qualifications in clinical 
nursing. The position is open for the 1 967-1 968 
session, with duties commencing July 1967. Please 
apply sending curriculum vitae and two references 
to : Director, School of Nursing, McMaster University, 
Hamilton, Ontario. 7-55-15 

FEBRUARY 1967 



Registered Nurses for 34 -bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462 3-wk. vacation with pay; sick leave after 
6-mo. service. All Staff - 5 day 40-hr, wk., 9 
statutory holidays, pension plan and other benefits. 
Apply to: Superintendent, Englehart & District Hos 
pital, Englehart, Ontario. 7-40- 1 



Registered Nurses. Applications and enquiries are 
invited for general duty positions on the staff of the 
Manitouwadge General Hospital. Excellent salary 
and fringe benefits. Liberal policies regarding ac 
commodation and vacation. Modern well -equipped 
33-bed hospital in new mining town, about 250-mi. 
east of Port Arthur and north-west of White River, 
Ontario Pop. 3,500. Nurses residence comprises indi 
vidual self-contained opts. Apply, staling qualifica 
tions, experience, age, marital status, phone number, 
etc. to the Administrator, General Hospital, Mani 
touwadge, Ontario. Phone 826-3251 7-74-1 A 

Registered Nurses: Applications are invited for Gener 
al Duty Staff Nurses; Gross salary range: $362 to 
$422. Supervisory advancement opportunities. Resident 
accommodations available; Hospital situated in tourist 
town off Lake Huron. For further information write: 
Superintendent, Saugeen Memorial Hospital, South 
ampton, Ontario. 7- 122-1 

Registered Nurses for 35-bed active treatment hospital, 
35 miles north east of Toronto, Ontario. Minimum 
salary $355 per month, and annual increments. Per 
sonnel policies including, Medical, O.H.S.C., weekly 
Indemnity Insurance, Ontario Hospital Pension Plan, 
and Group Life Insurance shared by the hospital, plus 
other benefits. Apply to: The Superintendent, The 
Cottage Hospital (Oxbridge), Uxbridge, Ontario. 



Registered Nurses for 18-bed (expanding to 36 bed) 
General Hospital in Mining and Resort town of 5,000 
people. Beautifully located on Wawa Lake, 140 miles 
north of Sault Ste. Marie, Ontario. Wide variety of 
summer and winter sports including swimming, boat 
ing, fishing, golfing, skating, curling and bowling. 
Six churches of different faiths. Salaries comparable 
with all northern hospitals. Limited bed and board 
available at reasonable rate. Excellent personnel 
policies, pleasant working conditions. Apply to: 
Director of Nursing, The Lady Dunn General Hospital, 
Box 179, Wawa, Ontario. 7-140-1 B 

Registered Nurses and Registered Nursing Assistants, 

for 100-bed General Hospital, situated in northern 
Ontario. Starting salary, Registered Nurses $390 per 
month. Registered Nursing Assistants $273 per month, 
shift differential, annual increment, 40 hour week, 
O. H. A. pension plan and group life insurance, 
O. H. S. C. and P. S. I. plans in effect. Accommoda 
tion available in residence if desired. For full par 
ticulars apply: The Director of Nurses, Lady Minto 
Hospital, Cochrcne, Ontario. 

Registered Nurses and Registered Nursing Assistants 

are invited to make application to our 75- bed, 
modern General Hospital. You will be in the Vaca 
tionland of the North, midway between the Lakehead 
and Winnipeg, Manitoba. Basic salaries are $371 
and $259, with yearly increments. Write or phone: 
The Director of Nursing, Dryden District General 
Hospital, DRYDEN, Ontario. 7-26-1 A 

REGISTERED NURSES AND REGISTERED NURSING 
ASSISTANTS (IMMEDIATELY) for a new 40-bed hos 
pital with nurses residence. Nurses - minimum salary 
$387 plus experience allowance, 3 semi-annual incre 
ments of $10 each. R.N.A. s - $270 plus experience 
allowance, 2 annual increments of $10 each. Reply to: 
The Director of Nursing, Geraldton District Hospital, 
Geraldton, Ontario. 7-50-1 

Registered Nurses and Registered Nursing Assistants 

for 160-bed accredited hospital. Starting salary $415 
and $285 respectively with regular annual incre 
ments for botn. Excellent personnel policies. Resid 
ence accommodation available. Apply to: Director of 
Nursing, Kirkland & District Hospital, Kirkland Lake, 
Ontario. 7-67-1 

Registered Nurses and Registered Nursing Assistants 

for 123-bed accredited hospital. Starting salary $400 
and $255 respectively with regular increments for 
both. Usual fringe benefits. For full information, 
apply to: Director of Nursing, Duffer in Area Hos 
pital, Orangeville, Ontario. Phone 941-2410. 7-90-1 



Registered Nurses and Registered Nursing Assistants: 

Applications are invited from R. N s and R. N. Ass ts. 
who are interested in returning to "nursing at the 
bedside" in a well-equipped General Hospital. Excel 
lent starting salaries and fringe benefits now. Further 
increase January 1, 1967, Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux Lookout General Hospital, P. O. Box 
909, Sioux Lookout, Ontario. 7-119-1 A 



Registered or Graduate Nurses, required for modern 
92-bed hospital. Residence accommodation $20 month 
ly. Overseas nurses welcome. Lovely old Scottish 
Town near Ottawa. Apply: Director of Nursing, The 
Great War Memorial Hospital, Perth, Ontario. 7-100-2 

Registered Nurses for General Duty in well-equipped 
28- bed hospital, located in growing gold mining 
and tourist area, north of Kenora, Ontario. Modern 
residence with individual rooms; room, board and 
uniform laundry only $45. 40-hr, wk,, no split shift, 
cumulative sick time, 8 statutory holidays and 28 
day paid vacation after one year. Starting salary 
$400. Apply to: Matron, Margaret Cochenour Memo 
rial Hospital, Cochenour, Ontario. 7-29-1 

Registered Nurses for General Duty and Operating 
Room, in modern 100-bed hospital, situated 40 miles 
from Ottawa. Excellent personnel policies. Residence 
accommodation available. Apply to: Director of 
Nursing, Smiths Falls Public Hospital, Smiths Falls, 
Ontario. 7-120-2A 



Registered Nurses for General Duty in 100-bed hos 
pita I, located 30-mi. from Ottawa, are urgently re 
quired. Good personnel policies, accommodation 
available in new staff residence. Apply: Director of 
Nursing, District Memorial Hospital, Winchester, On 
tario. 7-144-1 

Registered Nurses for General Duty and Operating 
Room in modern iiospital (opened in 1956). Situated 
in the Nickel Capital of the world, pop. 80,000 
people. Salary $372 per mo., with annual merit 
increments, pks annual bonus plan, 40-hr, wk. Recog 
nition for experience. Good personnel policies. Assist 
once with transportation can be arranged. Apply: 
Director of Nursing, Memorial Hospital, Sudbury, 
Ontario. 7-127-4 



General Duty Nurses for 66* bed General Hospital. 
Starting salary: $375/m. Excellent personnel policies. 
Pension plan, life insurance, etc., residence accom 
modation. Only 10 min. from downtown Buffalo. 
Apply: Director of Nursing, Douglas Memorial Hos 
pital, Fort Erie, Ontario. 7-45-1 

General Duty Nurses for active General 77- bed Hos 
pital in heart of Muskoka Lakes area: salary range 
$400 $460 with consideration for previous experience; 
excellent personnel policies and fringe benefifs:nurses 
residence available. Apply to: Director of Nursing, 
Huntsville District Memorial Hospital, Huntsville, On 
tario. 7-59-1 

General Duty Nurses for 100-bed modern hospital. 
Southwestern Ontario, 32 mi. from London. Salary 
commensurate with experience and ability; $398/m 
basic salary. Pension plan. Apply giving full par 
ticulars to: The Director of Nurses, District Memorial 
Hospital, Tillsonburg, Ontario. 7-131-1 

General Duty Nurses, Certified Nursing Assistants & 
Operating Room Technician (1) for new 50-bed hos 
pital with modern equipment, 40-hr, wk., 8 statutory 
holidays, excellent personnel policies & opportunity 
for advancement. Tourist town on Georgian Bay. 
Good bus connections to Toronto. Apply to: Director 
of Nurses, General Hospital, Meaford, Ontario. 7-79-1 

General Staff Nurses and Registered Nursing Assis 
tants are required for a modern, well-equipped General 
Hospital currently expanding to 167 beds. Situated in 
a progressive community in South Western Ontario, 30 
miles from Windsor-Detroit Border. Salary scaled to 
experience and qualifications. Excellent employee 
benefits and working conditions plus an opportunity 
to work in a Patient Centered Nursing Service. Write 
for further information to: Miss Patricia McGee, B. 
Sc.N., Reg.N. Director of Nursing, Leamington District 
Memorial Hospital, Leamington, Ontario. 7-69-1 A 

OPERATING ROOM NURSES (2) for a fully ac 
credited 70-bed General Hospital. For Operating 
Room Duty, Salary according to experience. Apply to-. 
O.R. Supervisor, Penetanguishene General Hospital, 
Penetanguishene, Ontario. 7-99-2 

Public Health Nurses for generalized program. Every 
modern fringe benefit. Full credit for experience. 
Present salary range $5,030 $6,148. Further, we 
are prepared to give consideration to any salary 
request. Apply to: E. G. Brown, M.D., D.P.H. Director 
and M.O.H., Kent County Health Unit, 21 - 7th. St., 
Chatham, Ontario. 7-24-4 



PUBLIC HEALTH NURSES (2 QUALIFIED) Staff 

positions available in the City of Oshawa. Duties to 
commence January 3rd, 1 967. General ized program 
in an official agency. Salary $5,658 to $6,507. 
Beginning salary according to experience. Liberal 
personnel policies and fringe benefits. Apply to: Mr. 
D. Murray, Personnel Officer, City Hall, 50 Centre 
Street, Oshawa, Ontario. 7-92-2 

THE CANADIAN NURSE 59 



NURSE- 
ANESTHETIST-OB" 



ONTARIO 



SASKATCHEWAN 



For 350 Bed Community 
Teaching Hospital, 35 min 
utes from Metropolitan New 
York. 

Excellent Salary 
+ Benefits 

In-service Education 

8 Paid Holidays per year 

Tuition Refund Program 

12 Paid Sick Days 

per year 

> Free Life and 

Disability Insurance 

Blue Cross Coverage 



Send Resume to: 

Box CN 1433, 

125 West 41 St. 

New York NY 10036 

An Equal Opportunity 
Employer M/F 



RIVERSIDE 

HOSPITAL 

OF OTTAWA 

A new, air-conditioned 340-bed 
hospital. Applications are called 
for Nurses for the positions of: 

HEAD NURSE Operating Room 
ASSISTANT HEAD NURSES 
GENERAL STAFF NURSES 

and 

REGISTERED NURSING ASSISTANTS 

Address all enquiries to: 
Director of Nursing 

RIVERSIDE HOSPITAL OF OTTAWA 

1967 Riverside Drive, 
Ottawa, Ontario 



Public Health Nurses for generalized programme in 
a County-City Health Unit. Salary schedule as of 
January 1, 1967, $5,100 to $6,100. 20 days vacation. 
Employer shared pension plan, P.S.I, and hospital- 
\zatlon. M)teage allowance or unit cars. Apply to : 
Miss Veronica O Leary, Supervisor of Public Health 
Nursing, Peterborough County-City Health Unit, P.O. 
Box 246, Peterborough, Ontario. 7-101-4A 



PUBLIC HEALTH NURSES for generalized public health 
program. Good personnel policies including 4 weeks 
vacation, sick time allowance, unit car or car allow 
ance, shared pension plan, hospitalization, and 
group insurance available. Apply to : Mrs. Muriel 
McAvoy, Secretary-Treasurer, Porcupine Health Unit, 
70 Balsam Street South, Timmins, Ontario. 7-132-2 



QUEBEC 



EXPO 67, NURSES, BE WISE . . . Reserve your room 
now for Expo 67. Semi-private rooms for one person 
in a modern home at 10 minutes from Expo grounds. 
Rate:$15 per day, including morning coffee and 
transportation to Expo site. Please write to: Mme 
Marguerite Richard, R.N., 3585, Beaufort, Ville Bros- 
sard. Quebec. 9-86-3 



GRADUATE NURSE for Private Camp in the Lauren- 

tians. JULY AND AUGUST 1967. Write: Pripstein s 
Camp Inc., 6344 MacDonald Avenue, Montreal 29, 
Quebec. 9-86-5 



OPERATING ROOM STAFF NURSES: (Applications are 
invited). In a modern 350-bed hospital. Salaries com 
mensurate with experience and postgraduate educa 
tion. Cumulative sick leave, 28 days anual vacation, 
retirement plan and other liberal fringe benefits. 
Apply: Director of Nursing Service, St. Mary s Hospital, 
3830 Lacombe Avenue, Montreal, Quebec. 9-47-39 A 



SASKATCHEWAN 



DIRECTOR OF NURSING for modern 24-bed active 
treatment hospital. Graduates in nursing administration 
or with experience will be given preference. Accommo 
dation available in nurses residence. Salary schedule 
will be based on the SRNA recommendations. Apply: 
Mr. R. Holinaty, Administrator, Wakaw Union Hospital, 
Wakaw, Saskatchewan. 10-131-1 A 

MATRON for the 20-bed, new, air-conditioned Cabri 
Union Hospital. Salary according to SRNA schedule. 
Residence accommodation available. Reply to: Mr. K. 
Exner, Secretary-Treasurer, Cabri Union Hospital, Ca 
bri, Saskatchewan. 10-13-2 



Registered Nurses (2) wanted immediately for the 
20-bed, air-conditioned, new hospital. Salary in ac 
cordance with the SRNA schedule. Residence accom 
modation available. Reply to: Mr. K. C. Exner, 
Secretary-Treasurer, Cabri Union Hospital, Cabri, Sas 
katchewan. 10-13-1 

Registered Nurses (2) for modern 30-bed General Hos 
pital at Shellbrook, Sask., 1967 salary $364 - $464 
accommodation available in new residence, rates 
nominal, personnel policies in accordance to SRNA. 
Shellbrook is 27 miles from city on Allweather High 
way, near Waskesiu summer resort. Write the Ad 
ministrator, Box 70 Shellbrook Union Hospital, 
Shellbrooke, Saskatchewan. 10-118-1 



REGISTERED NURSES for 24-bed active treatment hos 
pital. Established personnel policies and pension plan. 
Salary range as per SRNA recommendations. Adjust 
ments to starting salary made for previous experience. 
Residence accommodation available at $43.50 per 
month. Apply: Mrs. Z. Johnson, Acting Director of 
Nursing, Wakaw Union Hospital, Wakaw, Saskatche 
wan. 10-131-1 

Registered Nurses for General Duty (2) in fully 
modern 27-bed hospital. Initial salary $364 per month. 
Personnel policies according to Sask. Reg. Nurses As 
sociation recommendations. New modern residence, 
excellent working conditions. Duties to commence 
when convenient. Apply to: Superintendent of Nursing 
Services, Kipling Memorial Union Hospital, Kipling, 
Saskatchewan. 10-59-1 



General Duty and Operating Room Nurses, also 
Certified Nursing Assistants for 560-bed University 
Hospital. Salary commensurate with experience and 
preparations. Excellent personnel policies. Excellent 
opportunities to engage in progressive nursing. Ap 
ply : Director of Personnel, University Hospital, Sas 
katoon, Saskatchewan. 10-116-4A 



INSTRUCTORS IN ALL NURSING AREAS required by 
School of Nursing, Regina, Saskatchewan. Offers 
3 year and 2 year programs. Enrolment 180. Pre 
ference given to applicants with experience in 
nursing education or nursing service. Degree prefer 
red. Salary as set by SRNA. Apply to: Director, 
School of Nursing, Regina Grey Nun s Hospital, 
REGINA, Saskatchewan. 10-109-7 



UNITED STATES 



REGISTERED NURSES Southern California Op 
portunities available 368-bed modern hospital in 
Medical-Surgical, Labor and Delivery, Nursey, Oper 
ating Room and Intensive and Coronary Care Units. 
Good salary and liberal fringe benefits. Continuing 
mservice education program. Located 10 miles from 
Los Angeles near skiing, swimming, cultural and edu 
cational facilities. Temporary living accommodations. 
Apply: Director of Nursing Service, Saint Joseph 
Hospital, Burbank, California 91503. 15-5-63 

REGISTERED NURSES needed for rapidly expanding 
general hospital on the beautiful Peninsula near 
San Francisco. Outstanding policies and benefits, 
including temporary accommodations at low cost, 
health coverage, fully refundable retirement plan, 
liberal shift differentials, no rotation, exceptional 
in-service and orientation programs, unlimited sick 
leave accrual, unlimited vacation accrual, sick leave 
conversion to vacation, tuition reimbursement. Ex 
cellent salaries based on experience. Contact Person 
nel Administrator, Peninsula Hospital, 1783 El 
Camina Real, Burlingame, California 697*^1061. 

1 5-5-20 B 

Registered Nurses: The Los Angeles County General 
Hospital has opportunities in all clinical areas. We 
invite your enquiries about positions available in pre 
mature nursery, neuro-surgery, pediatrics, operating 
room and recovery room, as well as general medical 
or surgical wards, Several specialty programs are 
planned for 1967. Starting salary with one year s ex 
perience in an accredited hospital is $591 per month, 
$624 after six months. Additional pay for o degree. 
Evening bonus approximately $60 per month. Nigh) 
bonus $50. Living quarters available on hospital 
grounds for at least 90 days. We will help you with 
California Registration. For further information, 
write: Mrs. Dorothy Easley, Box 1311 CN. Los Angeles 
County General Hospital, 1200 North State Street, Los 
Angeles, California 90033. 15-5-3 E 

REGISTERED NURSES Opportunities available at 
415-bed hospital in Medical-Surgical, Labor and 
Delivery, Intensive Care, Operating Room and Psy 
ch iat y. No rotation of shift, good salary, evening 
and night differentials, liberal fringe benefits. 
Temporary living accommodations available. Apply: 
Miss Dolores Merrell, R.N., Personnel Director, Queen 
of Angels Hospital, 2301 Bellevue Aevnue, Los 
Angeles 26, California. 1 5-5-3G 

REGISTERED NURSES SAN FRANCISCO Children s 
Hospital and Adult Medical Center hospital for men. 
women and children, California registration required. 
Opportunities in all clinical areas. Excellent salaries, 
differentials for evenings and nights. Holidays, vaca 
tions, sick leave, life insurance, health insurance and 
employer- pa id pension-plan. Applications and details 
furnished on request. Contact Personnel Director, Chil 
dren s Hospital, 3700 California Street, San Francisco 
18, California. 15-5-4 




RED CROSS 

IS ALWAYS THERE 
WITH YOUR HELP 



60 THE CANADIAN NURSE 



FEBRUARY 1967 



UNITED STATES 



)0gisf*red Nurses, Career satisfaction, interest and 
arofessional growth unlimited in modern, JCAH ac 
credited 243-bed hospital. Located in one of Califor- 
lia s finest areas, recreational, educational and cul 
tural advantages are yours as well as wonderful 
/ear- round climate. If this combination is what 
you re looking for, contact us now Staff nurse en 
trance salary above $500 per month; increases to 
$663 per month; supervisory positions at highest 
rates. Special area and shift differentials to $50 per 
month paid. Excellent benefits include free health 
and life insurance retirement, credit union and liberal 
personnel policies. Professional staff appointments 
available in all clinical areas to those eligible for 
California licensure. Write today: Director of Nursing, 
Eden Hospital, 20103 Lake Chabot Road, Castro Val 
ley, California. 15-5-12 



REGISTERED NURSES : Mount Zion Hospital and Me 
dical Center s increased salary scales now double our 
attraction for nurses who find they can afford to live 
by the Golden Gate, Expansion has created vacancies 
for staff and specialty assignments. Address enquiry 
to: Personnel Department, 1600 Divisadero Street, San 
Francisco, California 94115, An equal opportunity em 
ployer. 15-5-4 C 

Registered Nurses for 303-bed modern hospital. Po 
sitions available Alt services, no shift rotation. 
Liberal benefits, advancement opportunities, educa- 



UNITED STATES 



UNITED STATES 



ONTARIO HYDRO 

requires 

REGISTERED NURSE 

with 

Public Health Nursing Certificate. Interest 
ing and responsible position located in 
Northern Ontario Hydro Colony. 

for further details please 
write to: 

Nursing Supervisor 

ONTARIO HYDRO 

620 University Avenue 

Toronto 2, Ontario 



SCHOOL OF NURSING 

PLUMMER MEMORIAL PUBLIC 
HOSPITAL 

SAULT STE. MARIE, ONTARIO 

Invites applicants for: 

1. Medical-Surgical Instructor 

2. Medical Instructor 

250-bed non-sectarian General Hospital 
with enrolment of 80 students. Salary 
commensurate with qualifications. 

Apply to: 

Principal, 
SCHOOL OF NURSING. 



tional opportunities in area, equal opportunity 
employer. Apply: Director of Nursing Service, Kaiser 
Foundation Hospitals, San Francisco 15, California. 
Phone (JO 7-4400) 15-5-57 



Registered Nurses California. Expanding, accredit 
ed 303-bed hospital in medical center of Southern 
California. University city. Mountain ocean resort 
area. Ideal year-round climate, smog free. Starting 
salary $6,300. With experience, $6,600. Fringe bene 
fits, shift differential, initial housing allowance. 
Wide variety rentals available. For details on Cali 
fornia License and Visa, write: Director of Nursing, 
Cottage Hospital, 320 W. Pueblo Street, Santa Bar 
bara, California 93105. 



hours from Lake Tahoe. Starting salary $510/m. 
with differentials. Apply: Director of Nurses, Mem 
orial Hospital, Woodland, California. 15-5-49B 




REGISTERED NURSES General Duty for 84-bed 
JCAH hospital 1 Va hours from San Francisco, 2 



nui iici ne unu uppjy, yerier u i uuty. Salary $425 

per month plus fringe benefits. Contact: Director of 
Nurses, Alamosa Community Hospital Alamosa, 
Colorado. 15-6-1 

STAFF NURSES: Needed to staff present fully accredit 
ed hospital and new facility to open December 1967. 
All services and shifts available. Good salaries and 
fringe benefits. Will pay transportation to and from. 
Minimum one year contract. For particulars concerning 
hospital and community write: L. E. Thompson, Ad"- 
ministrator, or V. Jenkins, Director of Nursing, Scioto 
Memorial Hospital, Portsmouth, Ohio. 15-36-4 




BOX 1311 C 
DOROTHY EASLEY, R.N. Nurse Recruitment Officer 

1200 North State Street 

Los Angeles, California 90033 

Telephone 213 225-3115 



Are you looking for career nursing opportunities ? 

Do you want more training? 
Do unusual services appeal to you? 

Then you will want 
more information about our hospital 

We are a university teaching hospital 
for two schools of medicine. 

We have over 200 internes, 300 residents 
and a full time medical staff. 

We are one of the world s 
largest medical centers. 

Starting Salary $560. OO/ month 

Credit for degree 

Shift differential 

Credit for experience 

Outstanding Promotional Opportunities 

Assistant Head Nurse or Charge Nurse 

Head Nurse 
Clinical Specialist; Teaching Assistant; Instructor 



Coronary Care Unit; P.A.R., Intensive Care Units; 

Chest Surgery; Jail; Premature Center; Admitting; 

General Medicine; O.R.; Diabetic Service; Neurosurgery; 

Metabolic Research; Dermatology; Orthopedics; Eye; Rehab; 

You name it We have it ! 



: EBRUARY 1967 



THE CANADIAN NURSE 61 



UNITED STATES 



UNITED STATES 



General Duty Staff Nurses for 450-bed fully approved 
reaching hospital. Top salaries with differential for 
evening and night duty. High increments. 40-hour 
week, paid vacation based on length of service, 8 paid 
holidays per year. Accumulative sick plan. Com 
prehensive hospital ization plan. Excellent pension 
plan. Orientation and dynamic in service program. 
Nurses Association (A.F.L.) governs hours, salaries 
and working conditions. Registration to work in 
California required. Address applications to: Chief 
Nurse, Southern Pacific Memorial Hospital, 1400 Fell 
Street, San Francisco, California 94117. 15-5-6 D 

ATTENTION GENERAL DUTY NURSES. 297-bed fully 
accredited County Hospital located 2 hrs. drive from 
San Francisco, ocean beaches, and mountain resorts in 
modern and progressive city of 40,000. 40 hr. 5 
day wk., pd. vacation, pd. holidays, pd. sick leave, 
retirement plan, social security, and insurance plan. 
Accommodations in Nurses Home, meals at reasonable 
rates, uniforms laundered without charge. Start $530 
ro $556 mo. depending on experience plus shift and 
service differentials. Merit increases to $644 mo. Must 
be eligible for Calif. Registration. Write Director of 
Nursing, Stanislaus County Hospital, 830 Scenic 
Drive, Modesto, California. 15-5-42 B 

Nurs for new 75-bed General Hospital. Resort 
area. Ideal climate. On beautiful Pacific ocean. 
Apply to: Director of Nurses, South Coast Com 
munity Hospital, South Laguna, California. 15-5-50 



Staff Duty positions (Nurss) in private 403-bed 
hospital. Liberal personnel policies and salary. Sub 
stantial differential for evening and night duty. 
Write: Personnel Director, Hospital of The Good 
Samaritan, 1212 Shatto Street, Los Angeles 17, 
California. 15-5-3b 

NURSE TEAM LEADER POSITIONS in new 372-bed, 
fully accredited. General Hospital in resort area. $461 
per month days and $485 per month evening and 
night shift. Liberal fringe benefits. For descriptive bro 
chure and policies write: L. Sims, North Miami Gene 
ral Hospital, 1701 NE 127th Street, North Miami 
Florida. 15-10-2 A 

REGISTERED NURSES: for 75-bed air conditioned 
hospital, growing community. Starting salary $330- 
$365/m, fringe benefits, vacation, sick leave, holi 
days, life insurance, hospitalization. 1 meal furnish 
ed. Write: Administrator, Hendry General Hospital, 
Clewiston, Florida. 15-10-1 

General Duty Nurses Present hospital 55-beds 
with new 75-bed hospital to open April, 1, 1965. 
Located on Lake Okeechobee near west Palm Beach. 
Liberal personnel policies, 40-hr, wk., bonus at end 
of first year. Minimum starting salary $380, with 
differential for evenings and nights. Apply: Director 
of Nursing Service, Glades General Hospital, P.O. 
Box 928. Belle Glade, Florida. 15-10-3 




NIGHT NURSE? 

University Hospital is pleased to announce that starting pay for night 

nurses now ranges from $30.00 to $33.00 per shift ($7,830 to $8,613 
for an annual starting salary) depending on education and experience. 
After 4 years service, night nurse salaries range up to $9,396.00 

per year. The base pay for permanent evening and rotating tours 
has also been increased plus excellent University Staff benefits are 

offered to all nurses. 

University Hospital has a Service Department which assigns trained 
personnel to handle paperwork and other non-nursing chores, 

relieving our nurses for patient care exclusively. 

Ann Arbor is nationally known as a Center of Culture with emphasis on 
art, music and drama and recognized as an exciting and desirable 

community in which to live. 

Write to Mr. George A. Higgins, A6001, University Hospital, 
University of Michigan Medical Center, Ann Arbor, Michigan for 
more information, or phone collect (313) 764-2172. 
We are an Equal Opportunity Employer 

UNIVERSITY OF MICHIGAN 
MEDICAL CENTER, ANN ARBOR 



NURSES, Registered, for modern 360-bed hospital. 
Openings available in all areas, medicine-surgery, 
delivery room, nursery, and postportum. Near Wayne 
State University, and an integral part of the new 
Medical Center. Salary $550 to $635 per month 
plus differential for afternoon and night. Premium 
pay for weekends. Good fringe benefits including 
Blue Cross and Life Insurance. Apply: Personnel 
Director, Hutzel Hospital formerly Woman s Hospital) 
432 East Hancock, Detroit, Michigan 48201. 15-23-1 F 



OPERATING ROOM NURSE 

Preference given postgraduate and/or ex 
tensive training. 

For 270-bed acute General Hospital in the 
interior of British Columbia. 



Apply to: 

Director of Nursing 

ROYAL INLAND HOSPITAL 

Kamloops, B. C. 



DIRECTOR OF NURSING 

The Salem Christian Sanitarium Associa 
tion Inc., which plans to open it s 30-bed 
private Psychiatric Hospital near Toronto 
in 1968, invites applications for the above 
position. Appointment will be made short 
ly to allow Director to participate in 
planning and to take special training if 
advisable. 

Apply to: 

Rev. J. VanHarmelen, 

Box 33, R.R. No. 2, 

Whitby, Ontario. 



REGISTERED NURSES 

For all services including Operating and 
Delivery Room. 

Hospital rapidly expanding to 450 beds. 
Salary $502 to $590 with shift, week-end 
and Charge Nurse differential. 



Write to Nursing Office 

ST. JOHN HOSPITAL 

22101 Moross Road 

Detroit, Michigan 48236 

or Telephone: 881-8200 

(4-11-24) 



62 THE CANADIAN NURSE 



FEBRUARY 1967 



OPPORTUNITY FOR 



GROWTH 

CHANGE 

SPECIALIZATION 



TORONTO GENERAL HOSPITAL 

Large centrally located University Teaching Hospital 

CONTINUE YOUR PROFESSIONAL GROWTH 

Planned orientation programme 

Continuing in-service programmes 

Opportunities of a research and teaching hospital 

BROADEN EXPERIENCE 
Positions available: 

General medicine Obstetrics Operating Room 

General Surgery Gynaecology Recovery Room - 

Specialty units and intensive core Cardiovascular 

Respiratory Neurosurgery 

ENJOY ADVANTAGES OF LIBERAL PERSONNEL POLICIES 

- Excellent patient care facilities 

Salaries scaled To qualifications and experience 

3 weeks vacation, statutory holidays, cumulative sick leave 

- Life insurance, hospitalization, retirement programme 
Uniforms laundered free 



For additional information, 

Director of Nursing 

TORONTO GENERAL HOSPITAL 

101 College Street, Toronto 1, Ontario 



; REGISTERED NURSES 

Lutheran General Hospital, Park Ridge, Illinois is a 
new 587-bed General Hospital, located in a pleasant 
suburb of Chicago. 

The hospital is modern with a wide range of services 
to patients, including Hyperbaric Oxygen Unit. Low- 
cost modern housing next to the hospital is available. 
The hospital is completely air-conditioned. 

Annual beginning salary is from $6,000 plus shift 
differential pay. Regular salary increments at six 
months of service and yearly thereafter. Sick leave 
and other fringe benefits are also available. 

Write or call collect: 
Director of Nursing Services 

LUTHERAN GENERAL HOSPITAL 

PARK RIDGE, ILLINOIS 60068 

Telephone: 692-2210 Ext. 211 
Area Code: 312 



SCARBOROUGH CENTENARY HOSPITAL 




Invites Applications For: 

ASSISTANT DIRECTOR 

OF ADMINISTRATIVE NURSING 

SUPERVISORS OF CLINICAL AREAS 

0. R. SUPERVISOR 

CASEROOM AND EMERGENCY STAFF 

This modern 750-bed hospital, scheduled to open in the Summer of 
1967, is fully equipped with the latest facilities to assist personnel 
in patient care and embraces the most modern concepts of team 
nursing. Excellent personnel policies are available. Progressive staff 
and management development programs offer the maximum op 
portunities for those who are interested. Salary is commensurate 
with experience and ability. 

For further information, please direct your enquiries to: 
Director of Nursing Service, 

SCARBOROUGH CENTENARY HOSPITAL 

Post Office Box 250, West Hill, Ontario 



: EBRUARY 1967 



THE CANADIAN NURSE 63 



OSHAWA 
GENERAL HOSPITAL 

GENERAL DUTY NURSES FOR 
ALL DEPARTMENTS 

Starting salary for Ontario Regis 
tered nurses $400 with 5 annual 
increments to $480 per month. 
Credit for acceptable previous 
service one increase for two 
years, two increases for four or 
more years. 

Non-registered -- $360.00 
Rotating periods of duty 3 
weeks vacation 8 statutory 
holidays. 

One day s sick credit per month 
beginning in the 7th month of 
service cumulative to 45 days. 
Pension Plan and Group Life 
Insurance Hospital pays 50% 
of Medical, Blue Cross and Hos 
pital Insurance premiums. 

Apply to: 
Director of Nursing 

OSHAWA GENERAL HOSPITAL 

Oshawa, Ontario 



ST. JOSEPH S 

HOSPITAL 
HAMILTON, 

ONTARIO 

A modern, progressive hospital, 
located in the centre of Ontario s 
Golden Horseshoe 
invites applications for 

GENERAL STAFF 
NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 

Immediate openings are avail 
able in Operating Room, Psy 
chiatry, Intensive Care Coro 
nary Monitor Unit, Obstetrics, 
Medical, Surgical and Paediatrics. 

For further information write to: 
THE DIRECTOR OF NURSING 

ST. JOSEPH S HOSPITAL 

Hamilton, Ontario 




UNIVERSITY OF ALBERTA 
SCHOOL OF NURSING 

Invites applications 
for instructors in : 

* Medical-Surgical Nursing 

* Paediatric Nursing 

for four-year basic degree 
programme 

and 

* Nursing Service Administration 
for post-basic degree programme 

Effective date of employment : 
July, 1967 

Salary in accord with University of Alber 
ta salary schedule and commensurate 
with qualifications and experience. Mas 
ter s degree or higher preferred. 

Apply to : 

RUTH E. McCLURE 

DIRECTOR, 

SCHOOL OF NURSING 

UNIVERSITY OF ALBERTA 

EDMONTON, ALBERTA 



STAFF NURSE POSITIONS 
Salary Range S482-S620 

with maximum starting $539 on day shift, 
$592 evening and/or night shifts. Credit 
given for education and/or experience. 
Opportunity to gain knowledge and skill 
in a specialized cancer research hospital. 
Registration in Texas required. Excellent 
personnel benefits include: 3 weeks vaca 
tion, holidays, cumulative sick leave, 
laundry of uniforms furnished, retirement 
and Social Security programs, Hospitaliza- 
tion, Life and Disability Income Insurance 
available. Equal opportunity employer. 

For application and additional information 
Write to : 

Personnel Manager 

THE UNIVERSITY OF TEXAS 

M.D, ANDERSON HOSPITAL AND 

TUMOR INSTITUTE 

Texas Medical Center 
Houston, Texas 77025 



ASSISTANT DIRECTOR 
OF NURSING 

Applications are invited for the 
above position in a fully ac 
credited 163-bed General Hos 
pital in beautiful Northern On 
tario. 

Desirable qualifications should 
include B.S.N. Degree with ex 
perience in supervision. 

For further information, 
Write to : 

Director of Nursing 

KIRKLAND and DISTRICT HOSPITAL 

Kirkland Lake, Ontario. 




ONTARIO SOCIETY 

FOR 

CRIPPLED CHILDREN 

requires 

Camp Directors 

General Staff Nurses 

Registered Nursing Assistants 

for 
FIVE SUMMER CAMPS 

located near 

OTTAWA COLLINGWOOD 

LONDON PORT COLBORNE 

KIRKLAND LAKE 

Applications are invited from nurses in 
terested in the rehabilitation of physically 
handicapped children. Preference given to 
CAMP DIRECTOR applicants having super 
visory experience and to NURSING ap 
plicants with paediatric experience. 

Apply in writing to: 

Miss HELEN WALLACE, Reg. N., 

Supervisor of Camps, 

350 Rumsey Road, 

Toronto 17, Ontario 



64 THE CANADIAN NURSE 



FEBRUARY 1967 




This is a little Eskimo boy 

Sometime during the next year, 
he might fall and hurt himself - 
or get measles or pneumonia. 

He will need the care of a nurse. 



A good nurse. 



Maybe you? 



Registered hospital and public health nurses, certified nursing assistants, 

for further information write to: 

MEDICAL SERVICES, DEPARTMENT OF NATIONAL HEALTH AND WELFARE, OTTAWA, CANADA. 



DIRECTOR OF NURSING 

Applications are invited 
for the 

POSITION OF DIRECTOR OF NURSING 

The Director of Nursing will be responsible for 
the administration of all nursing services within 
the hospital. The hospital currently operates 
375 beds and is undergoing extensive moderni 
zation and expansion costing $3,750,000. There 
is a furnished apartment available at a mini 
mum rental. A 140 student School of Nursing 
housed in a modern residence and operated 
by the hospital is the responsibility of a Director 
of Nursing Education. 

Address enquiries to: 
DOUGLAS M. McNABB, Administrator 

McKELLAR GENERAL HOSPITAL 

Fort William, Ontario 




THE SCARBOROUGH 
GENERAL HOSPITAL 

Invites applications from General Duty Nurses. 
Excellent personnel policies. An active and stimulat 
ing In-Service Education and Orientation Programme. 
A modern Management Training Programme to as 
sist the career-minded nurse to assume managerial 
positions. Salary is commensurate with experience 
and ability. We encourage you to take advantage 
of the opportunities offered in this new and expand 
ing hospital. 

For further information write to: 

Director of Nursing 

SCARBOROUGH GENERAL HOSPITAL 
Scarborough, Ontario 



FEBRUARY 1967 



THE CANADIAN NURSE 65 



THE HOSPITAL 



FOR 



SICK CHILDREN 




OFFERS: 



1. Satisfying experience 

2. Stimulating and friendly en 
vironment. 

3. Orientation and In-Service 
Education Program. 

4. Sound Personnel Policies 

5. Liberal vacation. 

APPLICATIONS FOR REGISTERED 
NURSING ASSISTANTS INVITED. 

For detailed information 
please write to: 

The Assistant Director 

of Nursing 
AUXILIARY STAFF 

555 University Avenue 
Toronto, Ontario, Canada 



NUMBER MEMORIAL HOSPITAL 

HOSPITAL 

Newly expanded 350-bed hospital. Progressive patient care con 
cept. 

SALARY 

General Staff Nurses (Currently Registered in Ontario) $400.00 - 
$480. 5-increments. 

Registered Nursing Assistants (Currently Registered in Ontario) 
$295.00 - $331.00, 3 increments. 

HOUSING - 

Furnished apartments available at subsidized rates. 

JOB SATISFACTION 

High quality patient care and friendly working environment. We 
appreciate our personnel and encourage their professional develop 
ment. 

You are invited to enquire concerning employment opportunities to: 
Director of Nursing 

NUMBER MEMORIAL HOSPITAL 

200 Church Street, Weston, Ontario 
Telephone 249-8111 (Toronto) 



CALGARY GENERAL HOSPITAL 

requires immediately 

REGISTERED GENERAL DUTY NURSES 



This is a modern 1,000-bed hospital including a new 
200-bed convalescent-rehabilitation section. Benefits 
include Pension Plan, sick leave, and shift differen 
tial plus a liberal vacation policy and salary range 
$360 - $420 per month commensurate with training 
and experience. 

Apply to: 

Director of Nursing Service 

CALGARY GENERAL HOSPITAL 

Calgary, Alberta 



66 THE CANADIAN NURSE 



FEBRUARY 1967 



What does 
Methodist Hospital 
have to offer me? 



At the Methodist Hospital, where research is a part 
of progress, a nursing career takes on new horizons 
rich in meaning and professional satisfaction. 

If you re looking for the chance to be the nurse 
you ve always dreamed of coming to the world 
famous Methodist Hospital can be an adventure 
almost like stepping into the future splendid 
facilities, so much advance equipment and 
everywhere the newest medical and patient care 
techniques are in use. 

Some of the best aspects of nursing at METHODIST 
are as old as medicine itself there is a spirit of 
kindness and consideration, and emphasis on patient 
care, that make this a hospital where nursing is 
satisfying and rewarding, day by day. 

Methodist Hospital is right in the center of the world s 
great Medical, Research and Educational complexes. 
HOUSTON is an exciting city rodeo and opera, 
pro-football and the famous Alley Theatre, water sports 
and beaches an hour or less away, the Houston 
Symphony and the Astrodome! 



A Few Quick Facts: We re affiliated with Baylor 
University College of Medicine and associated with 
Texas Woman s University College of Nursing. 
New $9Vz million Cardiovascular and Orthopedic 
Research Center will open soon. Our Inservice 
Education Department gives you thorough 
orientation, and continued instruction in new 
concepts and techniques. You ll find every 
encouragement to broaden your skills, 
including tuition assistance in obtaining 
further education in nursing. 



Send for Your Colorful Informative Illustrated 
Brochure ... to learn about Methodist Hospital, 
Houston, positions available, salary and employment 
benefits, tuition allowance, complimentary room 
accommodation and our Nurse Specialist Programs. 
Write, call or send coupon, Director of Personnel, 
The Methodist Hospital, Texas Medical Center, 
Houston, Texas 77025 



Director of Personnel, THE METHODIST HOSPITAL , Texas Medical Center, Houston, Texas 77025 j 

Please send me your brochure about nursing opportunities at THE METHODIST HOSPITAL Texas Medical Center I 

I 



Adflrpss 


1 

1 11 


l-ity 


1 




(PWIip 





} UNIVERSITY 
OF ALBERTA 
HOSPITAL 

Positions are available in our 
rapidly expanding Medical Cen 
tre situated on a growing Uni 
versity campus. All service in 
cluding renal dialysis, coronary 
intensive care and cardiac surg 
ery offer opportunities for ad 
vancement. 

Apply to: 
Director of Nursing 

UNIVERSITY OF ALBERTA 
HOSPITAL 

Edmonton, Alberta 



REGISTERED NURSES 

for General Duty 

In modern 20-bed hospital locat 
ed in thriving northwestern On 
tario community. Starting salary 
$335 minimum to $400 maxi 
mum for three years experience. 
Board and room in modern 
nurses residence is supplied at 
no charge. Excellent employee 
benefits and recreational facili 
ties available. Further particulars 
on request. Apply giving full 
details of experience, age, avail 
ability, etc. to: 

Employment Supervisor 

MARATHON CORPORATION 
OF CANADA LIMITED 

Marathon, Ontario 



OPERATING ROOM 
SUPERVISOR 

Required for 270-bed General 
Hospital with construction of a 
new hospital due to completion 
in 1967, increasing the bed ca 
pacity to 450. Included in the 
new hospital will be the most 
modern operating room complex 
based on the Friesen Concept of 
material and equipment supply. 
Excellent fringe benefits with 
generous sick leave, four weeks 
vacation and contributory pen 
sion plan. 

For further information write: 
Director of Nursing Service 

BELLEVILLE GENERAL HOSPITAL 

Belleville, Ontario. 



EBRUARY 1967 



THE CANADIAN NURSE 67 



ONTARIO SOCIETY 

FOR 

CRIPPLED CHILDREN 




Invites applications from Public 
Health Nurses who have at least 
2 years experience in general 
ized public health nursing, pre 
ferably in Ontario. 

INTERESTING AND VARIED 

PROFESSIONAL SERVICES 

IN AN EXPANDING PROGRAM 

INCLUDE: 

an opportunity to work direct 
ly with children, their parents, 
health and welfare agencies, 
and professional groups 

participation in arranging 
diagnostic and consultant cli 
nics 

assessing the needs of the 
individually handicapped child 
in relation to services provided 
by Easter Seal Clubs and the 
Society. 

Attractive salary schedule with 
excellent benefits. Car provided. 
Pre-service preparation with sa 
lary. 



Apply in writing to: 

Director, Nursing Service, 
350 Rumsey Road, 
Toronto 17, Ontario 



Registered Nurses 

AND 

Registered 
Nursing Assistants 

For 300-bed Accredited General 
Hospital situated in the pictur 
esque Grand River Valley. 60 
miles from Toronto. 

Modern well-equipped hospital 
providing quality nursing care. 
Excellent personnel policies. 

For further information write: 
Director of Nursing Service 

SOUTH WATERLOO 
MEMORIAL HOSPITAL 

Gait, Ontario 



REGISTERED NURSES 

250-bed General Hospital, ex 
panding to 400, located in San 
Francisco, California. Positions on 
all shifts for nurses in Intensive 
Care Unit, Operating Room, and 
General Staff Duty. Salary range 
effective April 1967, $6004700. 
Health and Life Insurance, Retire 
ment Program all hospital 
paid. Liberal holiday and vaca 
tion benefits. Accredited medical 
residencies in Medicine, General 
Surgery, Neuro Surgery, Ortho 
pedics, and Plastic Surgery. 

For further information write to: 

Miss Lois Jann, 
Director of Nursing 

FRANKLIN HOSPITAL 

14th and Noe Streets, 
San Francisco, California 



THE 

NORTHWESTERN 
GENERAL 
HOSPITAL 




THE HOSPITAL 

Fully accredited 
Progressive 250 bed hospital 
Planned expansion to 400 beds 
20 minutes to downtown Toronto. 

YOUR PROFESSIONAL GROWTH 

Planned orientation programme 
Continuing inservice education. 

BENEFITS INCLUDE 

3 weeks vacation 
8 statutory holidays 
Cumulative sick leave 
Group life insurance 
Hospitalization 
40 hour week. 

HOUSING 

Furnished apartments at reduced rates. 



For information contact: 
Director of Nursing 

NORTHWESTERN 
GENERAL HOSPITAL 

2175 Keele St., 
Toronto 15, Ont. 



68 THE CANADIAN NURSE 



FEBRUARY 1961 



PALO ALTO-STANFORD 
HOSPITAL CENTER 

Located on the beautiful campus of Stanford University in Palo Alto, California. 




"We invite you to join our professional staff and to gain unparalled experiences in 
nursing." 

For additional information 

NAME: 

ADDRESS: 

CITY: STATE: 

SERVICE DESIRED: 

Return to: p ALO ALTO-STANFORD HOSPITAL CENTER 

Personnel Department 

300 Pasteur Drive 
Palo Alto, California 



REGISTERED NURSES 

REGISTERED NURSING 
ASSISTANTS 

REQUIRED FOR 

ST. MARY S HOSPITAL 

TIMMINS, ONTARIO 

MODERN 200 BED HOSPITAL 

EXCELLENT PERSONNEL POLICIES 

PLEASANT TOWN OF 30,000 

WIDE VARIETY OF SUMMER 

AND WINTER SPORTS - 

SWIMMING, BOATING, 

FISHING, GOLFING, SKATING, 

CURLING, TOBOGGANING, 

SKIING AND ICE FISHING. 

Apply to: 
Director of Nursing Service 

ST. MARY S HOSPITAL 

Timmins, Ontario 



VICTORIA HOSPITAL 

LONDON, ONTARIO 

Modern l,000-bed hospital 
Requires 

Registered Nurses for 
all services 

and 

Registered 
Nursing Assistants 

40 hour week Pension plan 
Good salaries and Personnel 
Policies. 

Apply: 
Director of Nursing 

VICTORIA HOSPITAL 

London, Ont. 



ST. JOSEPH S HOSPITAL 

TORONTO, ONTARIO 

REGISTERED NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 

700-bed fully accredited hospital provides 
experience in Operating Room, Recovery 
Room, Intensive Care Unit, Pediatrics 
Orthopedics, Obstetrics, General Surgery 
and Medicine. 

Orientation and Active Inservice program 
for all staff. 

Salary is commensurate with preparation 
and experience. 

Benefits include Canada Pension Plan, 
Hospital Pension Plan, Group Life Insu 
rance. Sick leave 12 days after one 
year, Ontario Hospital Insurance 50% 
payment by hospital. 

Rotating Periods of duty 40 hour week, 
8 statutory holidays annual vacation 
3 weeks after one year. 

Apply: 

Assistant Director of 
Nursing Service 

ST. JOSEPH S HOSPITAL 

30 The Queensway 
Toronto 3, Ontario 



EBRUARY 1967 



THE CANADIAN NURSE 69 




: 



YORK COUNTY HOSPITAL 

NEWMARKET, ONTARIO 
HOSPITAL: 

A newly expanded 257 bed hospital with such progressive 

patient core concepts as a 12-bed I.C.U., 22-bed psychiatric 

and 24-bed self care unit. 
IDEAL LOCATION: 

45 minutes from downtown Toronto, 15-30 minutes from 

excellent summer and winter resort areas. 
SALARIES: 

Registered Nurses: $372-$447 per month. 

Registered Nursing Assistants: $277-$310 per month. 
BENEFITS INCLUDE: 

Furnished apartments, medical and hospital insurance, group 

life insurance, pension plan, 40 hour week. 

Please address all enquiries to: 
Director of Nursing 

YORK COUNTY HOSPITAL 

596 Davis Drive 
Newmarket, Ontario 



ADDITIONAL CLINICAL TEACHERS 

required 

to assist in Developing New Curriculum and a 

Regional School. 
School of Nursing Building is New 

and well equiped. 

Salaries and Fringe Benefits at Metropolitan Level. 
Qualifications B.Sc.N. 

or 
Diploma in Nursing Education. 



GENERAL STAFF NURSES 

Required for all Services 
Salaries and Fringe Benefits at Metropolitan Level. 



Apply to : 
DIRECTOR OF NURSING 

BRANTFORD GENERAL HOSPITAL 

Brantford, Ontario 



MAIMONIDES HOSPITAL 
AND HOME FOR THE AGED 

AN OPPORTUNITY 

A CHALLENGE 

A NEW EXPERIENCE.... 

SUPERVISORS, STAFF NURSES, NURSING 
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC 
NURSE: 

We invite you to join the nursing staff of New Mai- 
monides. 

LIBERAL VACATION .... HEALTH AND 
PENSION PLANS .... SALARIES COM 
MENSURATE WITH RECOGNIZED SCALES 

Apply to: 

DIRECTOR OF NURSING 

5795 Caldwell Avenue 
Montreal 29, Quebec 



THE ST. CATHARINES 
GENERAL HOSPITAL 

A modern 500-bed hospital located in the heart 
of the beautiful Niagara Peninsula, within 
easy travel distance from Buffalo, Hamilton 
and Toronto, invites applications from: Gener 
al Staff Nurses. 

Pleasant working conditions. Excellent per 
sonnel policies. 



Apply: 
The Director of Nursing Service 

THE ST. CATHARINES 
GENERAL HOSPITAL 

St. Catharines, Ontario 



70 THE CANADIAN NURSE 



FEBRUARY 196! 



DIRECTOR 
OF SCHOOL OF NURSING 

Applications are invited for the above position in a 
School of Nursing intending to revise programme in 
Fall of 1967 to a two year programme with a third 
year of experience in hospital nursing service. The 
School of Nursing is a new self-contained educational 
building, opened in 1964, with enrollment of ap 
proximately 140 students. 

Trent University is situated in Peterborough. 

Minimum requirement - - Bachelor s Degree. Salary 
will be commensurate with qualifications and ex 
perience. 

for further details apply to: 
Chairman of Nursing Education Committee, 

PETERBOROUGH CIVIC HOSPITAL 

Peterborough, Ontario 



KOOTENAY LAKE GENERAL HOSPITAL 

invites applications for the position of 

DIRECTOR OF NURSING 



The position involves administration of the patient care services of 
a 100-bed modern, accredited general core hospital with medical, 
surgical, obstetrics and paediatric services. Nursing service staff 
comprises 38 graduate nurses, 20 practical nurses and orderlies and 
5 p.n. trainees. 

The Director of Nursing would be directly responsible to the 
Administrator. 

Graduation from an approved School of Nursing essential with 
experience or preparation in patient care administration desirable. 

Location of the hospital is Nelson in the Kootenay Lake Region 
of Southeastern British Columbia, centre of Notre Dame University, 
Kootenay School of Art and B.C. Vocational Training School. It is 
an area of stable economy, temperate climate with varied edu 
cational, cultural, commercial, industrial, administrative and resort 
activity. 



Please direct enquiries or applications stating 
experience, training and references to: 

Administrator, 

KOOTENAY LAKE GENERAL HOSPITAL 

3 View Street, Nelson, B. C. 



MORRISTOWN MEMORIAL HOSPITAL 

MORRISTOWN, NEW JERSEY 





W -5525555 

: """." ;. *z$ : - - 




unlimited 

professional opportunities. 



EBRUARY 1967 



Morristown Memorial is a modern, full-service, 355-bed regional 
hospital center with excellent opportunities for specialization and 
advancement in all types of positions within the general and spe 
cialty fields. All services are accredited. Our planned orientation 
and continuing in-service training programs are managed by a full- 
time director and supervised by physicians, nurses, and specialists 
in related fields. Three nearby universities offer opportunity for 
advanced study. 

Here at Morristown Memorial you can further your professional 
development while enjoying the advantages of life in a friendly 
suburban community only 30 miles away from the heart of New 
York City. Attractive, low-cost apartments are available within our 
own buildings located but a few steps from the Hospital s entrance. 



Minimum starting salaries are: 

$120.00 weekly (day) $520.00 monthly 

$136.15 weekly (3-11 or 11-7) .... $590.00 monthly 

In addition, we provide a liberal program of fringe benefits. 
You advance to supervisory positions on merit; promotions 

are made from within. 
New Jersey has no state income tax. 

For full information concerning nursing opportunities, write to: 

Miss Ruth C. Anderson, R. N., Asst. Administrator 

Morristown Memorial Hospital, Morristown, New Jersey 

THE CANADIAN NURSE 71 



WOODSTOCK GENERAL HOSPITAL 

Requires 

GENERAL STAFF NURSES 

ALL DEPARTMENTS 

and 

O.R. TECHNICIANS 

Apply: 

Director of Nursing 

WOODSTOCK 
GENERAL HOSPITAL 
Woodstock, Ontario 



PORT COLBORNE 
GENERAL HOSPITAL 

PORT COLBORNE, ONTARIO 

STAFF NURSES 

required 

For 1 66-bed hospital within easy driving 
distance of American and Canadian me 
tropolitan centres. Consideration given for 
previous experience obtained in Canada. 
Completely furnished apartment-style resi 
dence, including balcony and swimming 
pool facing lake, adjacent to hospital. 

Apply: 
Director of Nursing 

GENERAL HOSPITAL 

Port Colborne, Ontario 



ST. JOSEPH S HOSPITAL 

LONDON, ONTARIO 

Teaching Hospital, 600 beds, new facilities 
requires : 

TEACHERS 

REGISTERED NURSES 
REGISTERED NURSING ASSISTANTS 

For further information apply : 

The Director of Nursing 

ST. JOSEPH S HOSPITAL 

London, Ontario 



McKELLAR GENERAL HOSPITAL 

requires 

Registered Nurses for general Staff. The 
hospital is friendly and progressive. 
It is now in the beginning stages of a 
$3,500,000 program of expansion and 
renovation. 

Openings in all services. 

Proximity to Lakehead University 
ensures opportunity for furthering 
education. 



For full particulars write to: 

Acting Director 
of Nursing Service 

McKELLAR GENERAL HOSPITAL, 
Fort William, Ontario. 



REGISTERED NURSES 

For new 100-bed General Hospital in 
resort town of 14,000 people, beautifully 
located on shores of Lake of the Woods. 
Three hours travel time from Winnipeg 
with good transportation available. Wide 
variety of summer and winter sports 
swimming, boating, fishing, golfing, skat 
ing, curling, tobogganing, skiing and ice 
fishing. 

Salary: $372 for nurses registered in 
Ontario with allowance for experience. 
Residence available. Good personnel poli 
cies. 

Apply to: 
DIRECTOR OF NURSING 

KENORA GENERAL HOSPITAL 

Kenora, Ontario 



DIRECTOR OF NURSING 
EDUCATION 

Master s degree preferred; to conduct 
basic nursing program and affilliate pro 
gram. 

Apply fo: 

Director of Nursing, 
CHILDREN S HOSPITAL 

OF WINNIPEG, 
Winnipeg, Manitoba. 



ST. JOSEPH S HOSPITAL 

SCHOOL OF NURSING 
Hamilton, Ontario 

require] 

CLINICAL INSTRUCTORS in all Nursing 
areas. Well-equipped, modern School of 
Nursing. Student enrolment over 300. 
Modern, progressive, 800-bed Hospital. 
Salary commensurate with preparation 
and experience. 

For further details, apply: 

DIRECTOR OF NURSING 



OTTAWA CIVIC HOSPITAL 

OTTAWA, ONTARIO 

This modern 1087-bed teaching hospital 
requires: 

REGISTERED NURSES 

FOR ALL SERVICES INCLUDING 
OPERATING ROOM AND PSYCHIATRY 

Excellent salaries, personnel policies and 
fringe benefits are available. 

Apply in writing to: 

B. JEAN MILLIGAN, Reg. N., M.A. 
Assistant Director 



ST. THOMAS-ELGIN 
GENERAL HOSPITAL 

Requires 

GENERAL STAFF NURSES 
REGISTERED NURSING 

ASSISTANTS 
O. R. TECHNICIANS 

Modern 395 bed, fully accredited General 
Hospital opened in 1954, with School of 
Nursing. Excellent personnel policies. 
O. H. A. Pension Plan. Pleasant progres 
sive industriol city of 22,500. 

Apply: 

Director of Nursing, 
ST. THOMAS-ELGIN GENERAL 

HOSPITAL 
St. Thomas, Ontario. 



72 THE CANADIAN NURSE 



FEBRUARY 1967 



OPERATING ROOM 
SUPERVISOR 

With Postgraduate Course in 

Operating Room technique 

and management 

Required for a 375-bed fully 
accredited General Hospital with 
projected reconstruction program. 
Salary based on qualifications 
and experience. 

Fringe benefits include hospital 
and medical coverage, generous 
sick leave, three weeks vacation 
and contributory pension plan. 

For further information write: 
Director of Nursing Service 

METROPOLITAN 
GENERAL HOSPITAL 

Windsor, Ontario 



RN s- 
LPN s 

Medical-Surgical 

Good starting salary 

In-service education 

12 paid sick days per year 

Tuition refund program 

Free life and 

disability insurance 



Send Resume to: 

Box 1434, 

125 West 41 St. 

New York, N.Y. 10036 

An Equal Opportunity 
Employer M/F 




THE WINNIPEG GENERAL HOSPITAL 

is Recruiting General Duty Nurses for all Services 

SEND APPLICATIONS DIRECTLY TO 

THE PERSONNEL DIRECTOR, 

WINNIPEG GENERAL HOSPITAL 

WINNIPEG 3, MANITOBA 



DIRECTOR, SCHOOL OF NURSING 

Applications are invited 
tor the 

POSITION OF DIRECTOR, 
SCHOOL OF NURSING 

The Director will have complete charge of two-plus-one 
diploma program with 360 students, adequate faculty, 
new ultra-modern facility associated with 1000-bed 
teaching hospital. Master s degree preferred. Considera 
tion will be given to candidate with Bachelor of Science 
in Nursing Education degree and good leadership poten 
tial. Appointment will be made by July 1, 1967. 

For further information, write to: 

Chairman, Nursing Advisory Committee 
c/o Nursing Office, 

VICTORIA HOSPITAL 

London, Ontario. 



EBRUARY 1967 



THE CANADIAN NURSE 73 



REGISTERED NURSES 

Staff positions available in acute and 
convalescent unit of large General Hospital 
located in San Francisco Bay Area. Starting 
salary $550 to $605 plus differential. Ex 
cellent benefits. 



Apply: 

SEQUOIA HOSPITAL 

Whipple and Alameda 

Redwood City, California 



REGISTERED NURSES 

required for 

82-bed hospital. Situated in the Niagara 
Peninsula. Transportation assistance. 

For salary rates and personnel policies, 
apply to: 

Director of Nursing 

HALDIMAND WAR MEMORIAL 
HOSPITAL 

Dunnville, Ontario 



SCHOOL OF NURSING 
WOODSTOCK GENERAL HOSPITAL 

Requires the following Faculty 

a) Psychiatric Teacher (One). 

b) Medical and Surgical Teachers (Two). 
Minimum requirement B. Sc. N. 

The above additional staff is required 
for New Program. 

Apply to: 

Director of Nursing Education 
WOODSTOCK GENERAL 

HOSPITAL 
Woodstock, Ontario 



222 BED GENERAL HOSPITAL 

requires 

STAFF NURSES 
REGISTERED NURSING ASSISTANTS 

Cornwall is noted for its summer and 
winter sport areas, and is an hour and a 
half from both Montreal and Ottawa. 
Progressive personnel policies include 4 
weeks vacation. Experience and post-basic 
certificates are recognized. 

Apply to: 

Ass t. Director of Nursing 

(service) 

CORNWALL GENERAL HOSPITAL 
Cornwall, Ontario 



DIRECTOR OF NURSING 

Applications are invited for the above 
position in a modern, 56-bed, fully ac 
credited hospital with expansion plans 
under active study. Nursing administrative 
education and experience desirable. 
Salary commensurate with qualifications. 

Apply: 

Mrs. M. Fearn, Executive Director 
THE BARRIE MEMORIAL 

HOSPITAL 
Ormstown,, Quebec 



SOUTH PEEL HOSPITAL 

COOKSVIUE, ONTARIO 

A new 450-bed General Hospital, located 
1 2 miles from the City of Toronto, has 
openings for: 

(1) GENERAL STAFF NURSES in all de 
partments; 

(2) Registered Nursing Assistants in all 
departments. 

for information or application, write to: 

Director of Nursing 

SOUTH PEEL HOSPITAL 

Cooksville, Ontario 



EVENING OR NIGHT 
SUPERVISOR 

For 70-bed active hospital located 70 
miles East of Saskatoon. Salary com 
mensurate with experience and qualifica 
tions. Excellent personnel policies. 

Apply : 

Director of Nursing Service 

ST. ELIZABETH S HOSPITAL 

Humboldt, Saskatchewan 



PETERBOROUGH CIVIC HOSPITAL 

School of Nursing requires 
INSTRUCTRESS (Nursing Arts) 
INSTRUCTRESS (Medical-Surgical Area) 

New self-contained education building for 
school of nursing now open. 

Trent University is situated in Peterborough 

For further information write to: 

Director of Nursing 
PETERBOROUGH CIVIC 

HOSPITAL 
Peterborough. Ontario 



SCHOOL OF NURSING 

PUBLIC GENERAL HOSPITAL 

Chatham, Ontario 

requires 

INSTRUCTORS 

Student Body of 130 

Modern self-contained education building 

University Preparation required with 

salary differential for Degree. 



for further information, 
apply to: 

Director, Nursing Education 



74 THE CANADIAN NURSE 



FEBRUARY 1% 



THE HOSPITAL 

FOR 

SICK CHILDREN 




YOU 



Receive the advantages of: 

1 . Five-week orientation pro 
gram for new staff. 

2. Ongoing in-service education 
for nurses. 

3. Extensive student education 
program. 

4. Research Institute. 

APPLICATION FOR GENERAL 
DUTY POSITIONS INVITED 



For information contact: 

THE DIRECTOR OF NURSING 

555 University Avenue 
Toronto, Canada 



DIRECTOR 

REGIONAL SCHOOL 
OF NURSING 

"KIRKLAND LAKE" 

Applications are invited for the 
position of Director of a new 
Regional School of Nursing to be 
established in Kirkland Lake with 
annual enrollment of 30 



an 



students encompassing five area 
hospitals. An excellent opportu 
nity to develop a program from 
the erection of the building to 
operating the school. 

Please direct enquiries to: 

The Secretary of the Steering 

Committee: 
R. J. Cameron, Administrator, 

KIRKLAND AND DISTRICT 
HOSPITAL 

Kirkland Lake, Ontario. 



DIRECTOR 
OF NURSING SERVICE 



The Belleville General Hospital 
requires a Director of Nursing 
Service to be responsible for the 
administration of all nursing ser 
vice activities. 

The hospital presently has a ca 
pacity of 300 beds and will in 
crease to a total of 450 beds in 
about one year, upon completion 
of a construction programme. 
The design incorporates a central 
Supply Process Dispatch system. 
Applicants should have a degree 
in nursing service administration 
as well as considerable expe 
rience in a similar position. 



Applications and enquiries 
should be addressed to: 

Acting Administrator 

BELLEVILLE GENERAL HOSPITAL 

Belleville, Ontario. 



OUR DIRECTOR 

OF NURSING 

needs you 




We re opening a brand new 120- 
bed addition and we need your 
help. We want our patients to 
have the finest of care as well as 
the finest of facilities. If you re a 
professional nurse who s inter 
ested in enhancing your own 
career as well as improving your 
hospital s scope of care, we 
need you. 




PRESBYTERIAN HOSPITAL CENTER 
ALBUQUERQUE, NEW MEXICO 87106 

"Starting salary to $555 a month 
"Expanding, progressive 

500-bed hospital 
"Personal orientation program 
"Liberal fringe benefits 
"Continuing educational programs 
"Airline travel paid 
"Two universities 
"Growing metropolitan area 
""Twenty minutes from nearby 

mountain ski area 

EQUAL OPPORTUNITY EMPLOYER 
Mail coupon orcall collect (505-243-9411, Eit. 219) 



Mrs. Susan Dicke Director of Nurse Recruitment 
Presbyterian Hospital Center. Department B 
Albuquerque. New Mexico 87106 

Please mail me more information about nursing 
at Presbyterian Hospital Center and how 1 may 
contribute to your patient care program. 

Name 


Addrns 


City 


Slat., 


School of Nursing 




Year "f RraHuafinn 


Month 







EBRUARY 1967 



THE CANADIAN NURSE 75 



GRADUATE NURSES 

Eligible for registration in the 
Province of Ontario. 

Various positions available as SUPER 
VISORS, HEAD NURSES, and GENERAL 
DUTY NURSES. Excellent opportunities for 
advancement in all areas of modern, 
newly expanded 1,000-bed General Hos 
pital, including O.R. and Recovery, Inten 
sive Care, Emergency, Central Supply, 
Medical and Surgical Units. 

Please contact: 

Director of Nursing 

HENDERSON GENERAL 

HOSPITAL 
Hamilton, Ontario 



REGISTERED GENERAL 
DUTY NURSES 

For 75-bed active hospital located 70 
miles East of Saskatoon. 

Excellent personnel policies. 

Apply : 

Director of Nursing Service 

ST. ELIZABETH S HOSPITAL 

Humboldt, Saskatchewan 



CAMPS HIAWATHA 

IN THE LAURENTIANS 

50 miles from Montreal and EXPO 

FOR GIRLS FOR BOYS 

To compose its Medical Staff 

for July and August 1967 

requires: 

A RESIDENT PHYSICIAN 

TWO (2) REGISTERED NURSES 

TWO (2) NURSES AIDES 

Staff for the full summer is preferred, but 
arrangements for one month may be had. 
Excellent food and living accommodations; 
Wonderful athletic and recreational faci 
lities. 

Please call or write: 

CAMPS HIAWATHA INC., 

1405 Bishop Street, 

Montreal 25, Quebec 

Tel.: 844-2556 






COLONEL BELCHER HOSPITAL 
CALGARY, ALBERTA 

EDUCATIONAL INSTRUCTOR 

Up to $6,283 per annum 

(depending on qualifications) 
Duties: to conduct in-service training for 

Nurses and Ancillary Staff. 
Qualifications: must be a Registered 
Nurse preferably with advanced train 
ing in nursing education and adminis 
tration. 

Apply immediately to the 

Personnel Office, 

COLONEL BELCHER HOSPITAL 

Calgary, Alberta 

Quote 998. 



SYDENHAM DISTRICT HOSPITAL 

WALLACEBURG, ONTARIO 

Expansion, scheduled to open April 1, 
1967. Registered Nurses salary range 
$400 - $480, per month commensurate 
with experience and qualifications. 

Registered Nursing Assistants salary 
range $295 -$331 per month. Excellent 
personnel polcies. 

For further information and application 
form please write: 

Mrs. M. Brevik 

Director of Nursing 

SYDENHAM DISTRICT HOSPITAL 

Wallaceburg, Ontario. 



NEW POSITION 
IN-SERVICE CO-ORDINATOR 

required 

to direct, supervise and participate in a 
program of In-Service Education. Require 
ments: Baccalaureate degree. Experience 
in nursing service and education. Keen 
interest in staff development. Initiative 
and leadership ability. 

Enquire: 

Director of Nursing 

ROYAL COLUMBIAN HOSPITAL 

New Westminster, B.C. 



OPERATING ROOM NURSES 
WE NEED 

YOU 

APPLY TO: 

Director of Nursing Service 

SUDBURY GENERAL HOSPITAL 

Sudbury, Ontario. 



PORT COLBORNE 
GENERAL HOSPITAL 

PORT COLBORNE, ONTARIO 
requires 

A Supervisor for evening and night rota 
tion of duty and A Supervisor for in- 
service education programme for 166-bed 
hospital within easy driving distance of 
American and Canadian metropolitan 
centres, consideration given for previous 
experience obtained in Canada. Comple 
tely furnished apartment-style residence, 
including balcony and swimming pool 
facing lake, adjacent to hospital. 

Apply: 

Director of Nursing 

GENERAL HOSPITAL 

Port Colborne, Ontario. 



ROYAL ALEXANDRA HOSPITAL 

EDMONTON, ALBERTA 

Modern active treatment hospital Super 
visors required for days, evening and 
night duty for Paediatric and Medical 
Nursing Units. General Duty for all servi 
ces including Intensive Care Unit. Excel 
lent working conditions and current per 
sonnel policies. Credit will be given for 
previous experience and Postgraduate 
qualifications. 

Apply: 

Personnel Office, 

ROYAL ALEXANDRA HOSPITAL 

Edmonton, Alberta 



76 THE CANADIAN NURSE 



FEBRUARY 196 




REGISTERED & GRADUATE 
NURSES 

Are required to fill vacancies in a modern, centrally 

located Hospital. Tours of duty are 7:30- 4:00, 3:30 - 

12:00 and 11:30-8:00. 

Salary range for Registered Nurses is $382.50 to 

$447.50 per month and for Graduate Nurses is 

$352.50 to $417.50 per month. We offer a full 

range of employee benefits and excellent working 

conditions. 

Day Care facilities for pre-school children from 3 

months to 5 years in age. 

Apply in person, or by letter to : 
Personnel Manager, 

THE RIVERDALE HOSPITAL 

St. Matthews Road, 
Toronto 8, Ontario. 



SCHOOL OF NURSING 

BROCKVILLE 
GENERAL HOSPITAL 

Requires 

TEACHERS 

For the recently approved two year curriculum with 
a third year of experience in nursing service. You 
will enjoy participating in the development of a 
progressive school which emphasizes planned learn 
ing experiences for the students. Theory is taught 
concurrent with clinical experience. 

Qualifications: Bachelor of Science in Nursing 

or Diploma in Nursing Education 
or Diploma in Public Health Nursing 

Excellent salaries and personnel policies. 

You would enjoy living in the attractive "City of 

the Thousand Islands" two and one half hours from 

Expo 67. 

For further information contact: 

The Director, School of Nursing 

BROCKVILLE GENERAL HOSPITAL 

Brockville, Ontario 




THE MONTREAL GENERAL HOSPITAL 

offers a 

6 month Advanced Course in 

Operating Room Technique and 

Management to 

REGISTERED NURSES 

with a year s Graduate experience 

in an Operating Room. 
Classes commence in September and 
March for selected classes of 
8 students 



For further information apply to : 
The Director of Nursing 

THE MONTREAL GENERAL HOSPITAL 

Montreal 25, Quebec 



DIRECTOR OF SCHOOL 
OF NURSING 

REQUIRED FOR 
DISTRICT SCHOOL OF NURSING 

Minimum Requirement -- B. Sc. N., with five years 
experience, two of these in Nursing Education. 

Apply to : 

Mr. Harold Swanson, Chairman, 
BOARD OF NURSING EDUCATION 

220 Clarke Street 
WOODSTOCK, ONTARIO 



BRUARY 1967 



THE CANADIAN NURSE 77 



UNITED STATES 



REGISTERED NURSES Just over the Golden Gate 
from San Francisco in "Marvelous Marin". Modern ex- 
ponding 250 bed hospital. Opportunities in medical, 
surgical obstetrical, ICU, OR, Cardiovascular, Psychia 
tric areas. Dynamic inservice program. Salary, based 
on education and experience starting from $600 to 
$675. PM and night shift differentials of 10% and 
7 %, plus liberal employee benefits. Opportunities for 
graduate study in nearby colleges and universities, 
Stimulating, progressive hospital atmosphere plus ex 
citing off-duty attractions of nearby San Francisco, 
the Redwoods, ocean swimming and mountain skiing. 
Contact: Personnel Director, Marin General Hospital, 
Box 30 San Rafael, California. 15-5-69 A 

REGISTERED NURSES CALIFORNIA Progressive hos 
pital in San Joaquin Valley has openings for R.N. s. 
Located between San Francisco and Los Angeles near 
mountain, ocean and desert resorts. Paid vacation, 
paid sick leave, paid Blue Cross, disability insurance, 
voluntary retirement plan. Salary range from $500 to 



$700 monthly. Write : Personnel Director, Mercy Hos 
pital, Bakersfield, California. 15-5-58A 

REGISTERED NURSES: Excellent opportunity for ad 
vancement In atmosphere of medical excellence. Pro 
gressive patient care including Intensive Care and 
Cardiac Care Units. Finely equipped growing 200- 
bed suburban community hospital just on Chicago s 
beautiful North Shore. Completely air conditioned 
furnished apartments, paid vacation, after six months, 
staff development program, and liberal fringe bene 
fits. Starting salary from $466. Differential of $30 
for nights or evenings. Contact: Donald L. Thomp 
son, R. N., Director of Nursing, Highland Park Hos 
pital, Highland Park, Illinois 60035. 15-14-3 A 

Registered Nurses and Certified Nursing Assistants. 

Opening in several areas, all shifts. Every other week 
end off, in small community hospital 2 miles from 
Boston. Rooms available. Hospital paid life insurance 
and other liberal fringe benefits. RN salary $100 per 
week, plus differential of $20 for 3-11 p.m. and 
11-7 a.m. shifts. C.N. Ass ts. $76 weekly plus $10 for 
3-11 p.m. and 11-7 a.m. shifts. Write: Miss Byrne, 
Director of Nurses, Chelsea Memmorial Hospital, 
Chelsea, Massachusetts 02150. 15-22-1 C 




SCHOOL FOR GRADUATE NURSES 
McGILL UNIVERSITY 



PROGRAMS FOR GRADUATE NURSES 

DEGREE OF BACHELOR OF NURSING 

Two years from McGill Senior Matriculation or three years from McGill Junior 
Matriculation or the equivalents. In First Year the student elects one clinical 
setting in which to study nursing, selecting from 

Maternal and Child Health Nursing 

Medical-Surgical Nursing 

Mental Health and Psychiatric Nursing 

Public Health Nursing 

In Final Year the student studies in nursing education, or nursing service 
supervision, selecting from 

Teaching of Nursing 

Supervision of Nursing Service in Hospitals 

Supervision of Public Health Nursing Service 

DEGREE OF MASTER OF SCIENCE (APPLIED) 

A program of two academic years for nurses with a baccalaureate degree. 
Students elect to major in: 

Development and Administration of Educational Programs in Nursing 

Nursing Service Administration in Hospitals and Public Health Agencies 

PROGRAM IN BASIC NURSING 

leading to the degree Bachelor of Science in Nursing 

A five-year program for students with McGill Junior Matriculation or its equivalent. 
This program combines academic and professional courses with supervised nursing 
experience in the McGill teaching hospitals and selected health agencies. This broad 
background of education, followed by graduate professional experience, prepares 
nurses for advanced levels of service in hospitals and community. 

for further particulars write to: 

DIRECTOR, McGILL SCHOOL FOR GRADUATE NURSES 

3506 UNIVERSITY STREET, MONTREAL 2, QUE. 




DALHOUSIE 
UNIVERSITY 



Degree Course in Basic Nursing (B.N.) 
4 years 

A program extending over four calendar 
years leading to the Bachelor of Nursing 
degree is offered to candidates with a 
Nova Scotia Grade XII standing (or equiv 
alent) and prepares the student for nursing 
practice in hospitals and the community. 
The curriculum includes studies in the 
humanities, nursing and the sciences. 

Degree Course for Registered Nurses 
(B.N.) 3 years 

A program extending over three academic 
years is offered to Registered Nurses who 
wish to obtain a Bachelor of Nursing 
degree. The course includes studies in 
the humanities, sciences and a nursing 
specialty. 

Diploma Courses for Registered Nurses 
1 year 

(1) Nursing Service Administration 

(2) Public Health Nursing 

(3) Teaching in Schools of Nursing 

for further information apply to: 
Director, School of Nursing 

DALHOUSIE UNIVERSITY 

Halifax, N.S. 



DALHOUSIE UNIVERSITY 
offers 

NEW DIPLOAAA PROGRAM 
in 

OUTPOST NURSING 

A program extending over two calendar 
years has been developed to prepare 
graduate nurses for service in remote 
areas of Northern Canada. Major areas 
within the course of study will include : 

Public health nursing 

Complete midwifery 

Basic clinical medicine 
Instruction will be highly individualized. 
1st year To be spent at the University. 
2nd year To consist of an internship 
directed by the University in 
selected northern agencies. 
Candidates should have completed at 
least one year of professional nursing. 
Upon completion of the program students 
will receive a Diploma in Public Health 
Nursing and a Diploma in Outpost 
Nursing. 

For further information write to: 

Director, 
SCHOOL OF NURSING 

DALHOUSIE UNIVERSITY 

Halifax, Nova Scotia 



78 THE CANADIAN NURSE 



FEBRUARY 19 



UNITED STATES 



STAFF NURSES Here is the opportunity to further 
develop your professional skills and knowledge in 
>ur 1 ,000- bed medical center. We have liberal personnel 
aolicies with premiums for evening and night tours. 
Our nurses residence, located in the midst of 33 
:ultural and educational institutions, offers low-cost 
lousing adjacent to the Hospitals. Write for our booklet 
>n nursing opportunities. Feel free to tell us what type 
Dosition you are seeking. Write: Director of Nursing, 
loom 600, University Hospitals of Cleveland, University 
lircle, Cleveland, Ohio 44-06 15-36-1 G 



legistered Nurse (Scenic Oregon vocation play 
ground, skiing, swimming, boating & cultural 
vents) for 295-bed teaching unit on campus of 
Jniversity of Oregon medical school. Salary starts 
it $575. Pay differential for nights and evenings. 



Liberal policy for advancement, vacations, sick 
leave, holidays. Apply: Multnomah Hospital, Port 
land, Oregon. 97201. 75-38-1 



Staff Nurst: Live with your family in an attractive 
2 bedroom furnished home for $55 per month, 
including utilities, and work in o suburban Cleve 
land hospital. Starting salary range $420 $445 
with 6 and 12 month increments. Excellent transpor 
tation to hospital door. Outstanding schools and 
cultural opportunities. Apply: Director of Nursing 
Service, Sunny Acres Hospital, 4310 Richmond Road, 
Cleveland, Ohio 44122. 15-36-1 E 



GRADUATE NURSES Wouldn t you like to work 
at a modern 532-bed acute General Teaching Hos 
pital where you would have: (a) unlimited oppor 
tunities for professional growth and advancement, 
(b) tuition paid for advanced study, (c) starting 
salary of $429 per month (to those with pending 
registration as well), d) progressive personnel poll- 



ROYAL VICTORIA HOSPITAL 

SCHOOL OF NURSING 



MONTREAL, QUEBEC 



POSTGRADUATE COURSES 

1. (a) Six month clinical course in Obstetrical Nursing. 

Classes September and March. 

(b) Two month clinical course in Gynecological Nursing. 
Classes following the six month course in Obstetrical 
Nursing. 

(c) Eight week course in Care of the Premature Infant. 

2. Six month course in Operating Room Technique. 
Classes September and March. 

3. Six month course in Theory and Practice in Psychiatric 
Nursing. 

Classes September and March. 



For information and details of the courses, apply to: 
DIRECTOR OF NURSING 

ROYAL VICTORIA HOSPITAL 

Montreal, P.O. 



cies, (e) a choice of areas? For further information, 
write or call collect: Miss Louise Harrison, Director 
of Nursing Service, Mount Sinai Hospital, University 
Circle, Cleveland, Ohio 44106. Phone SWeetbriar 
5-6000. 1 5-36-1 D 



STAFF NURSES: University of Washington. 320-bed 
modern, expanding Teaching and Research Hospital 
located on campus offers you an opportunity to 
join the staff in one of the following specialties: 
Clinical Research, Premature Center, Open Heart 
Surgery, Physical Medicine, Orthopedicts, Neyrosur- 
gery, Adult and Child Psychiatry in addition to 
the General Services. Salary: $501 to $576. Unique 
benefit program includes free University courses after 
six months. For information on opportunities, write 
to: Mrs. Ruth Fine, Director of Nursing Services, 
University Hospital, J959 N.E. Pacific Avenue, 
Seattle, Washington 96105. 15-48-2D 



UNIVERSITY OF 
BRITISH COLUMBIA 

School of Nursing 

DEGREE COURSE IN BASIC 
NURSING 

DEGREE COURSE FOR 
GRADUATE NURSES 

Both of these courses lead to the 
B.S.N. degree. Graduates are pre 
pared for public health as well as 
hospital nursing positions. 

DIPLOAAA COURSES FOR 
GRADUATE NURSES 

1. Public Health Nursing. 

2. Administration of Hospital 
Nursing Units. 

3. Psychiatric Nursing. 

For information write to: 
The Director 

SCHOOL OF NURSING 
UNIVERSITY OF B.C. 

Vancouver 8, B.C. 



OPERATING ROOM NURSE 

FOR 

DEEP RIVER HOSPITAL 

Must have successfully completed a post 
graduate course in operating room tech 
niques or have had two or three years 
experience. Fringe benefits include super 
annuation, holidays, group insurance, hos 
pital and medical plans. 

State all particulars in first letter to: 

FILE 11 E 
ATOMIC ENERGY O CANADA 

LIMITED 
Chalk River, Ontario. 



EBRUARY 1967 



THE CANADIAN NURSE 79 



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for all services including operating room, 
recovery room, intensive care and emergency 
in completely new wing. 

Salary range for General Staff positions 

$360.00 - $420.00 per month 

and other liberal benefits. 



Direct enquiries to: 
Director of Nursing, 

VICTORIA GENERAL HOSPITAL 

Halifax, Nova Scotia 



Index 

to 

advertisers 

February 1967 



Abbott Laboratories Ltd 14, 15 

Ames Company of Canada Ltd 17 

Bland Uniforms Limited 9 

Boehringer Ingelheim Products 20 

British Drug Houses (Canada) Ltd 52 

The Clinic Shoemakers 2 

Canadian University Service Overseas 26 

Department of National Defense, Ottawa 22 

Four Seasons Travel 19 

Charles E. Frosst & Co 16 

W. J. Gage Co. Ltd 21 

Lakeside Laboratories (Canada) Ltd 5 

Lewis-Howe Company (Turns) 57 

J. B. Lippincott Co. of Canada Ltd 24 

Mead Johnson of Canada Ltd 54 

C.V. Mosby Co 11 

J. T. Posey Company 6 

Reeves Company 12 

W. B. Saunders Company 1 

Sterilon of Canada 53 

Uniforms Registered Cover III 

United Surgical Corporation 55 

White Sister Uniforms Inc. Cover II 

Winthrop Laboratories Cover IV 



Advertising 

Manager 

Ruth H. Baumel, 

The Canadian Nurse 

50 The Driveway, 

Ottawa 4, Ontario 

Advertising Representatives 
Richard P. Wilson, 
219 East Lancaster Avenue, 
Ardmore, Penna. 19003 

Vanco Publications, 
1 70 The Donway West, 
Suite 408, Don Mills, Ont. 

Member of Canadian 
Circulation Audit Board Inc. 



80 THE CANADIAN NURSE 



FEBRUARY 1967 



March 1967 



UNIVERSITY OF OTTAWA, 
SChOOL OF NURSING 
OTTAWA, ONT. 

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PRINCIPLES OF CHEMISTRY 

The revised and updated new edition of this widely- 
adopted text is a well-rounded, authoritative presentation 
of the fundamentals of inorganic, organic and physiological 
chemistry for nurses. Practical applications of chemistry to 
nursing are made throughout this new edition. New chap 
ters discuss: milliequivalents; nucleoproteins and nucleic 
acids; electrolyte balance; water balance; acid-base bal 
ance; biochemistry of genetics. The new interpretation of 
the mechanism of chemical reaction is explained and the 
distribution of electrons in the shells and subshells of the 
outer structures of atoms is discussed in detail. 

By JOSEPH H. ROE, Ph.D. Publication date: March, 1967. 10th edition, 
approx. 412 pages, 6 3 / 4 " x 9 3 / 4 ", 55 illustrations, 3 in color. About 

A New Book! 
PEDIATRIC NURSING 

Effectively integrating psychological aspects of child care 
with a clear, comprehensive description of pediatric nurs 
ing, this authoritative new text incorporates the best 
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testing, common psychometric tests, normal nutrition and 
mental retardation. Specialized areas of clinical pediatrics 
and information on growth and development are discussed 
in great depth. The latest thinking is presented on: care 
of the child with congenital heart disease; common inborn 
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utero. 

By HELEN C. LATHAM, R.N., B.S., M.L., M.S.: and ROBERT V. 
HECKEL, B.S., M.S., Ph.D. With the collaboration of ROBERT P. 
THOMAS, M.D., and MARGARET MOORE, B.S., R.N. Publication date: 
May. 1967. Approx. 640 pages, 7" x 10", 139 illustrations. About 

$8. 1 0. 



New 5th Edition! 

A LABORATORY GUIDE IN CHEMISTRY 

The new edition of this completely up-to-date manual pre 
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tion and thin-layer chromotography. Though designed for 
use with the new 10th edition of Roe, PRINCIPLES OF 
CHEMISTRY, it easily adapts to use with any required text. 

By JOSEPH H. ROE, Ph.D. Publication date: March, 1967. 5th edition, 
approx. 240 pages, 5>/ 2 " x SY 2 ", 12 illustrations, 2 color plates, 
figures A to L. About $4.05. 



New 4th Edition! 

CARE OF THE PATIENT IN SURGERY 

Including Techniques 

Presenting the newest concepts and approaches in care of 
the patient in the operating room, the thoroughly revised, 
superbly illustrated new edition of this popular text em 
phasizes fundamental principles in providing authoritative 
guidance in all aspects of the nurse s duties in surgery. Two 
entirely new chapters, "Surgery on the Ear" and "Ophthal 
mic Surgery," have been added. Basic requirements of an 
operating room nursing service are definitively explained, 
including a new approach to surgical suite design. The 
most recent advances in chest, heart and gynecologic sur 
gery are discussed in detail . 

By EDYTHE LOUISE ALEXANDER, B.S., M.A., R.N.; WANDA BURLEY, 
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approx. 810 pages, 7" x 10", 555 illustrations, 5 in color. About $15.70. 



THE C. V. MOSBY COMPANY, LTD. 

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(ARCH 1967 




Publishers 



THE CANADIAN NURSE 1 






J 



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2 THE CANADIAN NURSE 



MARCH 1%: 



The 

Canadian 
Nurse 




A monthly journal for the nurses of Canada published 

in English and French editions by the Canadian Nurses Association 



Volume 63, Number 3 



March 1967 



26 Katherine E. MacLaggan - - A Tribute 

29 Medical Care of Eskimo Children 

32 Nursing in the North 

34 Outpost Nursing 

36 Drug Dependency Research - 

Expensive Luxury or Necessary Commodity? 

39 Use of Narcotics in Addict Therapy 

42 Care of Patients Addicted to Non-narcotic Drugs 

45 Deserter of People? 

47 Standardization George T. Maloney 

49 Hospital and Health Care What Price? S. J. Maubach 



N. Steinmetz 

Ruth E. May 

Ingeborg Paulus 

Robert Halliday 

Mary L. Epp 

Jean Wilkinson 



The views expressed in the various articles are the views of the authors and do not 
necessarily represent the policies or views of the Canadian Nurses Association. 



4 Letters 
7 News 
18 Names 

21 In a Capsule 

22 New Products 



23 Dates 

51 Research Abstracts 

53 Books 

58 Films 

88 Official Directory 



Cover photo courtesy National Health and Welfare, Ottawa. 



Executive Director: Helen K. Mussallem . 
Editor: Virginia A. Lindabury . Assistant 
Editor: Glennis N. Zilm . Editorial Assistant: 
Carla D. Penn Circulation Manager: Pier 
rette Hotte . Advertising Manager: Ruth H. 
Baumel . Subscription Rates: Canada: One 
Year, $4.50; two years, S8.00. Foreign: One 
Year, S5.00; two years, $9.00. Single copies: 
50 cents each. Make cheques or money orders 
payable to The Canadian Nurse . Change of 
Address: Four weeks notice and . the old 
address as well as the new are necessary. Not 
responsible for journals lost in mail due to 
errors in address. 
Canadian Nurses Association, 1966 



Manuscript Information: "The Canadian 
Nurse" welcomes unsolicited articles. All 
manuscripts should be typed, double-spaced, 
on one side of unruled paper leaving wide 
margins. Manuscripts are accepted for review 
for exclusive publication. The editor reserves 
the right to make the usual editorial changes. 
Photographs (glossy prints) and graphs and 
diagrams (drawn in india ink on white paper) 
are welcomed with such articles. The editor 
is not committed to publish all articles sent, 
nor to indicate definite dates of publication. 
Authorized as Second-Class Mail by the Post 
Office Department, Ottawa, and for payment 
of postage in cash. Postpaid at Montreal. 
Return Postage Guaranteed. 50 The Driveway, 
Ottawa 4. Ontario. 



ARCH 1967 



We mourn the death of our 
President, Katherine E. MacLaggan. 
The poignancy of our grief is 
intensified by knowing that one of the 
country s greatest leaders in nursing 
has been taken from us prematurely. 
Our consolation lies in the legacy 
of inspiration and example that she 
bequeathed to us. 

Our greatest tribute to the late 
president will be found not in words, 
but in action action that 
continues her work and builds on 
and elaborates her beliefs. 

Dr. MacLaggan s objective was 
to make the Canadian Nurses 
Association the strongest force for 
nursing leadership in the country. 
She was convinced that CNA haa to 
speak out on issues affecting nurses 
and nursing, and had to be the 
body that generates action. She also 
was convinced that the Association 
had underestimated its own power 
for exerting influence. "We are 
80,000 members banded together," 
she often said, "and we have never 
tapped our resources." 

"Think big" was a frequent 
admonishment from Dr. MacLaggan 
when there was temptation to place 
expediency first. She believed that if 
Association objectives were to be 
achieved, we could no longer "think 
small" in terms of money, resources, 
or other decisions that would affect 
future generations of nurses. 

Dr. MacLaggan always "thought 
big." Those who continue her work 
can do no less. -- Editor. 

THE CANADIAN NURSE 3 



letters 



Letters to the editor are welcome. 

Only signed letters will be considered for publication 

Name will be withheld at the writer s request. 



Revised income tax act 

Dear Editor: 

I was delighted to read "Wanted a 
Revised Income Tax Act" (Editorial, Jan 
uary, 1967). Hoorah for you. We have 
been quiet far too long. 

Many of us mothers wonder whether it 
is worthwhile to continue to put our skills 
and knowledge to work. You have revived 
the spark in us. Guide us in speaking "loud 
ly enough and in unison." 

I would like to congratulate the staff 
on the excellent issues that have been 
published. (Mrs.) J. Fedak, B.Sc.N., 
Toronto, Ontario. 



Dear Editor: 

We have sent a copy of your editorial 
(January, 1967) with a covering letter to 
our local M.P. and a petition with 64 names. 
Maybe our action will spur on other nursing 
groups to do the same. (Mrs.) O. Raws- 
thorne, inservice education instructor, Vic 
toria General Hospital, Winnipeg, Man. 



Not censored 

Dear Editor: 

An R.N. South Africa stated in "letters" 
(November 1966) that pages 17 and 18 
had been removed from her June 1966 
issue. She stated "...the mail is censored 
here and I would like to know what was on 
the page that made them tear it off." 

I checked the particular issue in the 
library of the South African Nursing As 
sociation and find that page 17 carries an 
advertisement by the Canadian Tampax 
Corporation offering free color charts of 
the standing female pelvic and reproductive 
organs. Page 18 carried the excellent "New 
Products" section. 

It seems that somebody was interested 
in the products advertised, for it is a fal 
lacy that mail is censored in this country. 
Dr. Charlotte Searle, director, Division of 
Professional Development, The South Afri 
can Nursing Association. 



Extra copies? 

Dear Editor: 

We are in need of copies of the January, 
February, and March 1966 issues of THE 
CANADIAN NURSE for our library and school 
of nursing. If any readers have copies of 
these issues available we would appreciate 
receiving them. R.N., Ontario. 

Available copies can be sent to The 
Canadian Nurse, 50 The Driveway, Otta 
wa 4, Ontario. Editor. 

4 THE CANADIAN NURSE 



University education 

Dear Editor: 

I wish to congratulate you and your co- 
workers for the last issue of L lnfirmiere 
Canadienne, which featured articles on uni 
versity nursing education. 

We were very pleased with its presenta 
tion and I am personally very proud to see 
it circulated throughout Canada and 
abroad. Sister Jacqueline Bouchard, 

Director, School of Nursing, Universite de 
Moncton. 

Dear Editor: 

I read with great interest the December 
issue, particularly the articles by Glenna 
Rowsell and Margaret Steed. Vera Osto- 
povitch, nursing service advisor, Saskat 
chewan Registered Nurses Association. 

Dear Editor: 

I enjoyed Glenna Rowsell s article in the 
December issue. I want to congratulate 
her on a fine job. Myrtle Pearl Stiver, 
former executive director of the Canadian 
Nurses Association. 

Dear Editor: 

I am very pleased to have an extra 
copy of THE CANADIAN NURSE for Decem 
ber, which contains the feature on "Uni 
versity School of Nursing in Canada." 

I think the article is very nicely done 
and of service not only to prospective 
students but to those of us in the schools 
who meet so infrequently. 

Please convey our appreciation to your 
staff members with whom we had a pleasant 
visit here in Montreal last summer. - 
Elizabeth Logan, Director, School for 
Graduate Nurses, McGill University. 

Dear Editor: 

Thank you for the complimentary copy 
of THE CANADIAN NURSE. I think the article 
is very well done and you will be pleased 
to know that as a result we have had ap 
plications to our school from other pro 
vinces. Joyce Nevitt, Director, School 
of Nursing, Memorial University of New 
foundland. 

Dear Editor: 

Thank you for your extra issue of THE 
CANADIAN NURSE with the article on the 
universities. It was a very kind gesture 
and I do wish to compliment you on this 
article. It will be most helpful, I am sure. 
Sr. Francoise Robert, s.g.c., director, 
University of Ottawa School of Nursing. 
Ottawa. 



From the four corners 

Dear Editor: 

I read with interest "Nurses on 
Move," a letter to the editor by Mis 
Rosemarie Gascoyne (October 1966) 
Could we have permission to reprint it 
our Philippine Journal of Nursing ? It 
be interesting reading for our nurses her 
in the Philippines. 

A suggestion that caught my attentio; 
is the possibility that the Internationa- 
Nurses Association could "produce a syster 
where a nurse would be acceptable an 
able to work in any country." I hope th 
ICN will be able to evolve a commo 
basic curriculum for approval of the bod 
at the coming ICN conference in Canadi 

I see a new look in The Canadia, 
Nurse. The cover page is pleasing to be 
hold ! Of all the magazines we have in out 
library, your journal is the most referre* 
to by students and graduate nurses. Jos 
E. Sumagaysay, executive secretary, Phi 
lippine Nurses Association. 

Dear Editor: 

Thank you for an excellent nursing maj 
azine which has become the best in ani 
country. For years I have been passing m 
copies on to students and graduates alikt 
and they all comment that THE CANADIAI 
NURSE has the best articles printed. 

"Letters" (January, 1967) was most in 
teresting to me, an obstetrical supervisoi 
but I believe the finest article was in th 
November, 1966 issue. I have read Mis 
Pepper s article over and over again. I wa 
reading between the lines as I knew all o 
the girls in the army pictures and spent som 
time in Italy with No. 14 C.G. HospitE 
during the war. Keep up the good work. - 
Marjorie (Lodge) Collister, Riverdale, I! 
linois. 

Dear Editor: 

I very much enjoy my monthly copy o 
THE CANADIAN NURSE. It is so informativ 
and up-to-date ! When one is away fror 
home, in another country, news of one 
fellow nurses is wonderful for the morale 
Ruth A. Jort, Des Moines, Iowa. 

Dear Editor: 

I enclose a draft for my subscription t 
THE CANADIAN NURSE for two further year. 

In my opinion this is the best of th 
nursing journals all articles on a specifi 
subject are contained in the same issu 
rather than in several. This saves the bothe 
of collecting them all together. W.P 
S.R.N., Cumberland, England. 

MARCH 196 



"In spite of today s apparent explosion 

in their awareness of sex, 
young people are not well informed." 



A recent study indicated that even 
among college girls enrolled in health 
education classes knowledge of menstru 
al facts was neither thorough nor accu 
rate. One reason, perhaps, for the lack 
of accuracy was the fact that only 8% of 
these girls obtained their information 
about menstruation from doctors, nurses 
or teachers. 

This small percentage probably 
learned about menstruation because 
they asked. Many young girls, however, never ask for 
information because they feel menstruation is not a 
subject for discussion outside their homes. (And 
sometimes very little information is available within 
their homes.) Even the doctor is not likely to be con 
sulted unless the girl is concerned about a possible 
abnormality. 

One solution to this problem is to make information 
on menstruation available to all young girls whether 




or not they specifically ask for it. Thus, 
girls in health and physical education 
classes, girls visiting school nurses, girls 
at summer camp, girls consulting their 
doctors all should be provided with in 
formation on the normal changes that 
are a part of growing up. 

To assist you in explaining menstru 
ation to these girls we offer you (without 
charge) laminated plastic charts drawn 
by Dr. R. L. Dickinson, showing schemat 
ic illustrations of the organs of the female reproduc 
tive system. For the young girl we provide two free 
booklets answering her questions about menstruation. 
Send for them today. Professional samples of Tampax 
menstrual tampons will also be included. 



1. Israel, S. Leon: Obst. & Gynec. 26:920, 1965. 2. Larsen. 
Virginia L: J. Am. M. Women s A. 20:557, 1965. 



TAMPAX 



SANITARY PROTECTION WORN INTERNALLY 

MADE ONLY BY CANADIAN TAMPAX CORPORATION .LTD., 
BARRIE, ONT. 



Canadian Tampax Corporation Limited, 
P.O. Box 627, Barrie, Ont. 

Please send free a set of Dickinson charts, copies of the two booklets, 
a postcard for easy reordering and samples of Tampax tampons. 

Name __^_ 



Address. 



ARCH 1967 



THE CANADIAN NURSE 5 



FLAGYL 




trichomonacide 



oral tablets of 250 mg 
vaginal tablets of 500 mg 



Full information is available on request 




oulenc 



6 THE CANADIAN NURSE 



MARCH 1967 



news 



Committee on Nursing Education 
Begins Biennium 

Canada s 188 nursing schools diploma 
and basic baccalaureate programs gradu 
ated a total of 7,360 nurses in 1965. This 
was an increase of only 99 over the previous 
year. This small increase is not sufficient to 
maintain present demands for nurses and 
could result in an increasing shortage of 
nurses with the coming of Medicare. 

These figures were presented by Mrs. Lois 
Graham-Gumming, Research Department, 
Canadian Nurses Association, to the Stand 
ing Committee on Nursing Education at its 
first meeting of the 1966-68 biennium in 
mid-February. 

They represent only one of the problems 
under consideration by the committee. 

Chairman Kathleen Arpin reminded the 
committee, comprised of the elected repre 
sentatives on nursing education from the 
10 provincial associations, that as a national 
organization the CNA must undertake to 
provide realistic policies and definitive state 
ments on nursing and nursing education. 
The committee s job is to investigate thor 
oughly and recommend appropriate policies 
to the Board for consideration and action. 

The committee is expected to examine 
certain specific areas of nursing education. 
Recommendations regarding a definitive 
statement on nursing, admission criteria in 
schools of nursing, and the need for and 
utilization of resources and facilities essential 
for the practice and learning of nursing will 
likely be made to the Board during the next 
biennium. 

Nation-wide Exams for 
Canadian Nurses? 

The first meeting of the Canadian Nurses 
Association s ad hoc committee on National 
Examinations was held in Ottawa on January 
23-25, 1967. The committee had been asked 
to explore and assemble all data pertinent 
to the development of a Canadian system 
of registration examinations (machine-scor 
ed), and to make recommendations to the 
CNA Board of Directors as to possible CNA 
involvement. 

The need for immediate action on Cana 
dian nursing examinations has arisen because 
the American Nurses Association recom 
mended at their meeting in June, 1966, that 
the National League for Nursing discontinue 
the use of examinations in jurisdictions out 
side the United States. The National League 
for Nursing has notified those provinces 
that are now using the examinations that 
they will not be available as of 1969. 

MARCH 1967 



CNA Auxiliary Meet 




Two members of the Canadian Nurses Association National Office Auxiliary, 
Miss E. Cale, President (right) and Mrs. G.P. Williams (left) examine a recent 
issue of The Canadian Nurse with Editor Virginia Lindabury. The Auxiliary, 
which was organized in 1955 to entertain international visitors and to help 
with the cataloguing and indexing of periodicals in the CNA library, held 
its annual meeting early in February at National Office. 



At the three-day meeting, the committee 
investigated measures for developing a Cana 
dian system of examinations, and considered 
interim measures for the provinces until such 
a service could be established. 

Mrs. Mary Shields, formerly of the Test 
Construction Unit of the National League 
for Nursing, was guest speaker at the meet 
ing. She spoke on the procedures and prob 
lems in the development of licensure exam 
inations. 

The committee has prepared recommenda 
tions for submission to the Board of Di 
rectors meeting in March. 



Official Opening - CNA House 

Her Excellency, Madame Georges P. 
Vanier, wife of Canada s Governor-General, 
will officially open the new home of the 
Canadian Nurses Association on Wednes 
day, March 15, 1967. 

The opening of CNA House will precede 
the meeting of the CNA Board of Directors 
on March 16 and 17 so that full repre 
sentation of all association members will be 
assured. 



On this occasion the Board, on behalf of 
all CNA members, will be host to state 
officials and representatives of national asso 
ciations and agencies who will be invited to 
attend the ceremonies. 

The first sod for the $800,000 building 
was turned on April 1, 1965. The office 
building provides 20,000 square feet of office 
space. Architect J.W. Strutt designed the 
building. 

Nurses Speak at Hospital 
Administrators Meeting 

Four nurses formed the faculty for a 
day at the Second Educational Assembly 
on Hospital Administration held by the 
American College of Hospital Administra 
tors, District 8, in Winnipeg early in Jan 
uary. 

Miss Margaret Steed, Consultant, Nurs 
ing Education for the Canadian Nurses 
Association; Miss Jean Anderson, Director 
of Nursing Service at Victoria Public Hos 
pital, Fredericton; Sister Therese Caston- 
guay, Superintendent of Nursing Educa 
tion for Saskatchewan; and Mrs. K. Mc- 
Laughlin, Research Analyst in Nursing at 
the Victoria General Hospital, Winnipeg, 

THE CANADIAN NURSE 7 



news 



examined the question "Who will give nurs 
ing care?" on the first day of the sessions. 

"Nursing care should be given by a 
nurse, qualified and registered for the prac 
tice of nursing. Until nursing care is ad 
ministered by nurses we cannot hope to 
solve our nursing service problems quali 
tatively," Miss Steed told the audience. 
She defined the CNA s recommendations 
regarding the two categories of nurses, their 
preparation and utilization as a means for 
improving patient care. "The care func 
tions are the ones now most often dele 
gated to nursing assistants and nursing 
aides." She noted that nursing service will 
need to be complimented by auxiliary per 
sonnel, but told the hospital administra 
tors that a need for interpretation and cla 
rification of the roles, functions, and res 
ponsibilities of all those employed to per 
form nursing services was essential. 

About 140 hospital administrators from 
across Canada attended the five-day meet 
ing. The seminar sessions on "problem 
areas," at which the nurses spoke, was 
limited to 50 delegates to ensure effective 
participation in the discussion. 

Institutes on New Educational 
Program in Saskatchewan 

A series of six workshops on nursing 
education are being sponsored by the Saska 
tchewan Department of Education, Nursing 
Education Division. The workshops are for 
teaching personnel in nursing schools and 
other persons interested in the proposed 
changes in nursing education in the province. 

Three workshops are scheduled for Regina 
and three for Saskatoon. They were organiz 
ed to help prepare nurse educators for 
changes that have revolutionized the pattern 
of nursing education within the province 
since the responsibility for nursing educa 
tion was transferred from the Department 
of Public Health to the Department of 
Education in April, 1966. 

The changes include the establishment of 
two regional schools and the closure of all 
existing hospital nursing programs. The first 
of the two regional schools is expected to 
open its doors to some 250 students this 
fall in Saskatoon. Hospital schools in Prince 
Albert, Humboldt, Yorkton, and Saskatoon 
will no longer admit students. No date has 
been set for the opening of the regional 
school for the southern region of the pro 
vince, and hospitals there will continue to 
operate existing programs. 

Miss D. Rowles, supervisor of the nursing 
program at Ryerson Polytechnical Institute 
in Toronto, was guest speaker at the first 
institute on January 17 in Saskatoon. She 
spoke on nursing programs within education 
al institutions. Dr. H.K. Mussallem, exe 
cutive director of the Canadian Nurses 

8 THE CANADIAN NURSE 



Auxiliary Donates Bus Shelter 




The Riverview Hospital Auxiliary in 
Windsor recently made a unique and 
practical contribution to patients and 
their visitors. At a cost of $1,650 the 
Auxiliary had a bus shelter built directly 
across from the hospital. 

According to Phyllis Purcell, public 
relations chairman of the Riverview 
Auxiliary, the need for a bus shelter to 
protect hospital visitors from the cold 
winds that blow across the Detroit River 
has been recognized for some time. Last 



year, the hospital board asked the Auxil 
iary to assume the cost of this project. 

The Auxiliary hoped to have a metal 
shelter built, but the cost was prohibitive. 
Realizing that the shelter did not have 
to be glamorous to serve its purpose, the 
Auxiliary settled for a wooden building. 
The design was approved by the city and 
the shelter erected. 

Now, both visitors and staff at River- 
view can await the bus in comfort 
thanks to an enterprising Auxiliary. 



Association, addressed the second meeting 
on February 24 in Regina. She stressed the 
need for nurses to welcome change in our 
nursing education practices, and pointed out 
that change was long overdue. 

Other workshops will be held in Regina 
on April 17-18, when Mrs. M. Levine of 
Chicago will speak on the selection of learn 
ing experiences, and in May, when Dr. R.N. 
Anderson will discuss the evaluation of stu 
dent performance. In Saskatoon, Miss H. 
Keeler, director of the nursing program 
at the University of Saskatchewan, will 
speak March 22 on the reasons for shorten 
ing nursing programs. In June, a workshop 
on teaching by principles will be directed 
by Mrs. R. M. Coombs of Hamilton, On 
tario. 

Sister Therese Castonguay, superintendent 
for the nursing education division of the 
department of education, anticipates that the 
workshops will aid existing faculty to pre 
pare for the coming programs. 

Brockville Nurses Certified 
As Bargaining Unit 

After almost a year s wait, the Nurses 
Association at Brockville General Hospital 
has been certified as a bargaining unit by 
the Ontario Labour Relations Board. The 
collective bargaining phase now can begin. 

The Nurses Association proposed that the 



bargaining unit consist of all registered and 
graduate nurses, both full-time and part- 
time, who are employed by the Brockville 
General Hospital. The hospital proposed a 
unit of "all graduate nursing staff regularly 
employed in the nursing units, nursery, 
emergency department, operating room, cen 
tral service and delivery room, save and 
except assistant head nurses and persons 
above that rank and daily basis relief nurses. 

The unit as finally certified by the On 
tario Labour Relations Board includes all 
registered and graduate nurses at B.G.H. 
who are engaged in nursing care and in 
teaching, except head nurses and persons 
above the rank of head nurse, and those 
regularly employed for not more than 24 
hours a week. 

The Labour Relations Board further stated 
that all registered and graduate nurses at 
B.G.H. who are engaged in nursing care 
and regularly employed for not more than 
24 hours per week "constitute a unit of the 
employees of the respondent appropriate for 
collective bargaining." 

The Brockville group is the third Nurses 
Association in Ontario to be certified as 
a bargaining unit. Nurses at Riverview Hos 
pital, Windsor, and at St. Joseph s General 
Hospital, Peterborough, were certified in 
1966. 

(Continued on page 10) 
MARCH 1967 



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10 THE CANADIAN NURSE 



(Continued from page 8) 

P.E.I. Discusses Collective 
Bargaining 

A three-phase plan of action for better 
salaries and working conditions for Prince 
Edward Island s nurses was proposed by a 
Conference on Socio-economic Welfare in 
Charlottetown in mid-January. 

Representatives from all but two of the 
Island s hospitals met for a three-day session 
on collective bargaining for professionnal 
personnel. Miss Glenna Rowsell, nursing 
consultant, Canadian Nurses Association, 
chaired the conference, which was attended 
by about 30 persons each day. 

The provincial association is presently 
unable to bargain under the Labour Rela 
tions Act in the province, and the nurses 
wished to ascertain the prospects for im 
proving their economic position through 
collective bargaining. PEI s nurses are among 
the lowest paid in Canada. 

The conference drew up a plan of action 
for the coming year. The first step is to 
inform the members about labor legislation 
and to discover the kind of legislation want 
ed. The association may then suggest the 
appropriate legislation and undertake to 
convince the provincial legislature of the 
practicability of the nurses stand. 

"This three-phase attack -- involvement 
of the members and promotion of educa 
tion on industrial relations legislation, fol 
lowed by an Association stand on the type 
of legislation suited to the needs of its 
nurses, followed by a concerted effort to- 
convince the legislature is a most in 
telligent and workable plan," reports Miss 
Rowsell. "It could eventually lead to more 
satisfied nurses and better patient care." 

Gifts to Archives 

The Mary Agnes Snively Archives Col 
lection at CNA House continues to grow. 
Three new gifts to the collection have 
recently been received. 

A collection of books, including a set of 
Keating s Cyclopedia of the Diseases of 
Children, 1890, was received from the 
Miramichi Hospital, Newcastle, N.B. A 
print depicting a hospital scene in Middle 
sex, England, in 1808 was donated by Lucy 
R. Seymer, author of various histories of 
nursing. 

The most recent addition was a memo 
rial plate presented by the Medicine Hat 
Chapter of the Alberta Association of Re 
gistered Nurses. 

CNA Librarian Margaret Parkin ex 
pressed interest in further additions, espe 
cially to the collection of early nursing 
caps. "We are anxious to receive the large 
and unusual ones worn in the 1800 s," 
she said. "We would like to receive any 
distinctive Canadian ones for a special 
Centennial year display." 

MARCH 1967 



news 



Quebec Nurses 
Granted Certification 

The United Nurses of Montreal, which has 
organized within District No. 1 1 of the Asso 
ciation of Nurses of the Province of Que 
bec, recently announced that the Quebec 
Labour Relations Board has granted certi 
fication to 10 groups of nurses in hospitals 
and health agencies. It is expected that the 
remaining 18 hospitals and agencies will 
receive certification as soon as the petitions 
are presented to the Labour Relations Board. 

The union includes nurses in both mana 
gement and non-management positions. 

All nurses in the district, both French 
and English, are invited to become members 
of the association. The United Nurses of 
Montreal now has an office located at 3506 
University Street, Room 14, Montreal. 

DBS to Survey Nurses Salaries 

The Dominion Bureau of Statistics will 
conduct a survey of salaries of graduate 
nurses employed in the public general and 
allied special hospitals of Canada. 

The survey, to be carried out this spring, 
is being undertaken with the active sup 
port of the Canadian Nurses Association 
and the Canadian Hospital Association, and 
with consultation from the Department of 
Manpower and Immigration. 

It is expected that survey results will 
be available in the summer in a published 
report by the Bureau. Salary data will be 
presented according to the graduate nurses 
employment category (directors, supervi 
sors, head nurses, teachers, general duty), 
their lay or religious status, and whether 
they are currently registered or not. The 
survey questionnaire will be designed so 
that hospitals will be able to provide the 
data from payroll or personnel records with 
a minimum of effort. 

The Canadian Nurses Association, with 
the support of the Canadian Hospital As 
sociation, requested the survey. Salaries 
of many professional types are available 
in Canada but nurses, of whom so many 
are employed in hospitals, do not have any 
valid salary information that can be com 
pared from region to region in Canada. 
The Dominion Bureau of Statistics has 
agreed, therefore, to approach hospitals in 
Canada and obtain from them the salary 
information from payroll data as of Feb 
ruary 28, 1967, for all full-time personnel 
employed in the nursing categories out 
lined. 

All graduate nurses who are employed 
on a full-time basis are to be included in 
this survey. If a nurse is employed in a 
dual position, her entry in the position in 
which she spends the major portion of her 
time will be recorded. 

MARCH 1967 



Space Suits For Nurses 



Nurses working in the operating rooms 
of the new 300-bed Riverside Hospital of 
Ottawa are becoming used to being teased 
about their "space suits." It is true, how 
ever, that their two-piece trouser-suits with 
the built-in boots do resemble costumes 
from a science-fiction TV serial. 

The use of the occlusive garb is a part 
of a two-year controlled federal-provincial 
research program on control of infections 
in operating rooms. 

Previous studies, such as the one carried 
out at the Barnes Hospital, St. Louis, have 
shown that the perineum, thighs, and feet 
are primary sources of viable bacteria and 
that these organisms become airborne in 
the course of normal activity. The neck, 
arms, and waist openings are apparently not 
important as sites for the escape of skin 
organisms. 

Conventional operating room dress per 
mits the escape of skin bacteria from the 
lower extremities, so the staff at River 
side are using a trouser and blouse outfit. 
The one-piece trouser-shoe outfit is made 
of an all-cotton tightly-woven fabric; a tie 
at the ankle provides for length adjustment. 
The shoe has the conductive sole. The tunic 
is three-quarter length with back fastenings 
and is made of regular cotton. A special 
over-boot is worn in the theatre as addi 
tional protection. 

The trouser-suits are worn only in the 
theatre section of the hospital. No one 
other than the operating room staff in their 
specially designed outfits and the patients 
ready for surgery are admitted to the 
operating room areas. 

Miss Olive Brissett, a graduate of Wan- 
stad Hospital, London, England, is shown 
modeling the outfit for THE CANADIAN NURSE. 









I 




Nurses Serve Abroad With 
External Aid 

A reputation for "quality, professionalism 
and flexibility" has been earned by Cana 
dian nurses, who represent 60 percent of 
those serving abroad under Canada s Ex 
ternal Aid Program. 

Whether as a staff nurse in Vietnam, a 
pediatric nurse in Tunisia, or a nursing 
instructor in Trinidad, the Canadian nurse 
is playing an important part in the External 
Aid Program. 

As part of its program the External Aid 
Office fills requests from various under 
developed countries for medical personnel. 

A file in the International Health Divi 
sion of the Department of National Health 
and Welfare contains the personal history 
forms of nurses interested in serving abroad. 
From this file and through consultations 
with the Canadian Nurses Association and 



the university schools of nursing, Dr. B.D.B. 
Layton, principal medical officer, is able 
to fill the requests for medical person 
nel. 

Salaries are arranged to be as attractive 
as possible. Above a basic salary, which 
is commensurate with World Health Organ 
ization and Pan American Health Program 
salaries, Canada s External Aid Program 
provides a non-taxable overseas allowance. 

To keep the program from defeating its 
purpose, a five-year maximum time limit 
has been set on overseas service. "In theory 
a country is setting out its own health 
plan," said Dr. Layton. "We provide tem 
porary help for the country, not careers 
for ourselves." 

In most cases, the Canadian nurses help 
to staff existing hospitals or schools of 
nursing. In Tunisia, the Canadian Govern 
ment has undertaken a different type of 

THE CANADIAN NURSE 11 



news 



project in agreement with the Tunisian 
government. The Hopital d Enfants in Tunis 
is being operated by a staff of 49 Canadians 
who fill positions as medical advisors, 
pediatric nurses, radiologists, and physio 
therapists. 

The challenges and opportunities that 
the External Aid Program offers are varied. 
Canadian nurses have become international 
ly known through their readiness to part 
icipate in all aspects of the program. 



Public Support Needed For 
Psychiatric Programs 

Voluntary organizations in mental health 
services are neglected, according to C.A. 
Roberts, executive director of the Clarke 
Institute of Psychiatry in Toronto. 

Dr. Roberts, who presented the first an 
nual C.M. Hincks Memorial Lectures at the 
University of Ottawa s Faculty of Medicine 
in February, appealed for more public sup 
port in mental health programs. "Where 
there is public apathy," he said, "poor health 
services result." 

Dr. Roberts pointed out that voluntary 
organizations can be very effective in chang- 




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ing public attitudes toward mentaJ illness 
and in removing the stigma that still sur 
rounds this type of illness. 

The Hincks Memorial Lectures, a tribute 
to Dr. Clarence M. Hincks, founder and 
first director of the Canadian Mental Health 
Association, will be presented annually in 
an Ontario university having a medical 
school. 

Invitations Available For 
Expo Attraction 

A series of 28 lectures to be presented 
by internationally known experts in their 
fields will be a feature attraction at Expo 
67 this year. 

Of special interest to nurses will be lec 
tures by Sir Macfarlane Burnet, Nobel 
Laureate (Medicine) from Australia, (June 
12th); Dr. William Barry Wood Jr., Direc 
tor of The Johns Hopkins University Depart 
ment of Microbiology, (June 19th); and Mr. 
K. Helveg Petersen, Authority of Adult Edu 
cation from Denmark, (June 26th). Other 
topics will range from "Development Trends 
in Contemporary Literature" to "Orient 
Pearls in the World Oyster." 

The lectures, sponsored by Noranda Mines 
Limited, will be delivered at the DuPont 
of Canada Auditorium located on the site 
of the Exhibition He Sainte-Helene. 

The modern auditorium is completely 
equipped for the simultaneous translation 
of lectures into either English or French. 
The lecture by Academician Mikhail Sho- 
lokhov, to be delivered in Russian, will be 
simultaneously translated into both English 
and French. 

Attendance at any of the one-hour lec 
tures is by special invitation only. Appli 
cations for invitations, or requests for in 
formation, should be sent to Mr. D. Hunka, 
Organizing Secretary, Science Programme, 
Expo 67, Mackay Pier, Montreal, P.Q. Ap 
plications, to be treated on a first-come- 
first-serve basis, can be accepted only in 
writing. 

Canadian Doctors Visit China 

At the invitation of the Chinese Medical 
Association three Canadian doctors visited 
the People s Republic of China for a five- 
day observation tour of Canton and Peking 
health facilities. 

Dr. R. K. C. Thompson, President of 
the Canadian Medical Association; Dr. 
Walter MacKenzie, Dean, Faculty of Me 
dicine, University of Alberta; and Dr. A. 
F. W. Peart, General Secretary, Canadian 
Medical Association, visited in mid-Novem 
ber to observe medical education, medical 
research and medical practice in China. 

The Chinese Medical Association had 
arranged for the visas for the delegation, 
and planned a tour that included visits to 
the Bethune Orthopedic Hospital (named 
after Dr. Norman Bethune, a Canadian 
physician who took part in the revolu 
tionary war and is considered a Chinese 
hero), various institutes of the Academy 

MARCH 1967 



news 



jf Medical Science of China, the Peking 
Medical College, the Red Star People s 
Commune, and the Canton Medical School. 
Dr. Peart reported that the Canadian 
delegation was impressed with the friend 
liness of the Chinese doctors and their 
associates, and their desire to have further 
:ontact with Canadian doctors. "Informa- 
;ion was given freely," Dr. Peart said, 
and we were not curtailed in taking pic 
tures. Although we deliberately avoided 
discussions about their revolution and the 
Communist philosophy, which is comple 
tely contrary to our way of life in Ca 
nada, we all felt that further exchanges 
Between the doctors of our two countries 
would be useful." 

Grant Approved for Ontario 
Hospital 

A federal grant of $115,053 for the 
I.O.D.E. Memorial Hospital in Windsor 
has been announced by National Health 
and Welfare Minister Allan J. MacEachen. 

The grant will assist the construction of 
an addition to the present hospital build 
ing. The addition, to be known as the 
Osmond Wing, will consist of two single 
story units. The two units will provide 52 
beds for the care of psychiatric patients, 
as well as space for community mental 
health services and teaching areas. 

Completion of construction is expected 
this month. 

WHO, UNICEF Try 
New X-ray Units 

New, simplified x-ray units specially 
designed for use in rural health centers in 
less developed countries or as stand-by 
equipment in large hospitals are being test 
ed by the World Health Organization. 

Cooperating in this venture are the United 
Nations Children s Fund (UNICEF) and 
leading manufacturers of x-ray equipment. 
Prototypes of different possible machines 
have been supplied by UNICEF to WHO 
for field trials in the Republic of the Congo 
(Brazzaville), Kenya, and Lesotho. 

X-ray machines are important tools in 
mass campaigns against tuberculosis and in 
other diagnostic work. However, the ma 
chines now being manufactured are primarily 
designed for use in hospitals and health 
centers of technically-developed countries 
and have been found too complicated for 
operation in rural areas of developing coun 
tries. Because of the lack of trained per 
sonnel to operate the machines or the meager 
or non-existent service facilities, units in 
many hospitals are out of order most of 
the time. 

Under the technical guidance of medical 
radiographers and physicists, WHO drew up 
specifications for a simple, multipurpose ma- 
MARCH 1967 




Nurses attending the Conference on Pediatric Nursing at the Hospital for Sick 
Children toured the ward areas to see current equipment and procedures. 



chine for use in these rural health centers 
and urban areas of developing countries. In 
the design, precautions have been taken 
against the possibility of radiation damage 
to the population. WHO anticipates requests 
from governments for the training of x-ray 
technicians and operators as a result of this 
trial. 

This investigation is of great value to all 
countries where the servicing and repair of 
x-ray apparatus present a problem. 

Outbreaks of Measles and 
Scarlet Fever in Quebec 

Measles and scarlet fever are currently 
approaching epidemic proportions in some 
regions of Quebec. The director of health 
for Quebec city, Dr. Jacques Roussel, has 
declared that the number of cases in his 
region is the highest in 10 years. The 
provincial minister of health is giving 
special attention to case-finding and treat 
ment of these two diseases. 

Dr. A.R. Foley, director of the Epide 
miology Service of the Department of 
Health, has pointed out that scarlet fever 
usually strikes children from 5 to 15 years 
of age. Even in a mild form the disease can 
cause permanent disability if not treated. 

At the early signs of scarlet fever, such 
as sore throat and pyrexia, it is advisable 
to consult a physician. Antibiotic and pro 
phylactic treatment is recommended for 
those children who have had contact with 
the disease. 

Measles is characterized by cold symp 
toms followed by a rash. In children under 
three years, the disease is often complicated 
by bronchopneumonia. 

Some doctors recommend administration 
of anti-measles vaccine, but mass vaccina 
tion programs do not appear to be the ideal 
solution at the present time. 



Pediatric Nursing Conference 

To inform, to up-date, to assist through 
talks, discussions and demonstrations 
these were the objectives of the three-day 
Conference on Pediatric Nursing held early 
in December at the Graduate Nurses Resi 
dence of the Hospital for Sick Children, 
Toronto. 

Sponsored by the Hospital for Sick 
Children Department of Nursing, the con 
ference demonstrated techniques and prac 
tices currently being developed and used 
to ensure comfort and safety in the care of 
young patients. Sixty-two nurses from 
throughout Ontario attended the continuing 
education session. 

Displays were set up by each of the 
six participating areas: recreation and 
volunteers; emergency; intensive care; new 
born and premature; medicine isola 
tion, and the committee for control of 
infection; and surgery including physio 
therapy, occupational therapy and dietary 
departments. 

The conference was designed to improve 
the nurses competence in such areas as 
the hospitalized child and his family; im 
portance of play for the hospitalized child; 
emergency nursing care of newborns and 
prematures; nursing care in a pediatric 
emergency department; factors to consider 
in creating a safe environment for chil 
dren; nursing in the intensive care unit; 
and meeting the needs of the long-term 
patient. 

Grants for Multiple Sclerosis 

Research grants totalling $81,994. were 
announced early in January by the Multi 
ple Sclerosis Society of Canada. 

Headed by Dr. John M. Silversides of 

Toronto, the Society s Medical Advisory 

Board meets annually to consider applica- 

THE CANADIAN NURSE 13 



news 



tions from scientists at Canadian univer 
sities and hospitals. After careful scrutiny, 
grants are awarded to those projects con 
sidered most appropriate. The research pro 
gram is coordinated with other areas of 
neurological research in Canada, the United 
States and Great Britain. 

Five Quebec grants, four of them to 
McGill University and the other to the 
University of Montreal, totaled $39,500.00. 



Four othei grants were announced to the 
Hospital for Sick Children, Toronto, the 
University of Western Ontario, the Uni 
versity of Saskatchewan, and the Univeisity 
of Toronto. 

To science, multiple sclerosis remains 
the greatest unsolved neurological problem 
of our time. There is no cure, not even 
a definite knowledge of its causes. How 
ever, the disease has struck an estimated 
30,000 Canadians, mostly in the 18-45 year 
age group. Among the symptoms of MS 
are blurred or double vision, tremors, loss 
of coordination, staggering or stumbling 
gait, speech difficulties, numbness, extreme 




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weakness and fatigue, and partial or com 
plete paralysis. 

The Multiple Sclerosis Society of Canada 
was founded 18 years ago and by the end 
of 1967 will have allocated $763,182.88 
for research and fellowship grants in an 
effort to determine the cause and possible 
treatment for this baffling neurological dis 
order. Additionally, through its 35 regional 
Chapters staffed by volunteers, the Society 
provides a Patients Services Program to 
patients and their families. Quebec Chap 
ters of the Society are active and the MS 
Society forms a part of the Combined 
Health Appeal of Greater Montreal. Head 
Office of the Society was recently trans- 
fered from Montreal to Toronto. 

New Vaccination Regulations 

A new International Certificate of Vac 
cination booklet has been in use since 
January 1, 1967 for all vaccinations per 
formed for international travel. The re 
vised form includes changes in the small 
pox and yellow fever certificates as amended 
by the Eighteenth World Health Assembly 
in May, 1965. 

The International Certificate of Vacci 
nation or Revaccination against Smallpox 
requires the physician to indicate that a 
vaccine that meets the World Health Or 
ganization s requirements was used. The 
origin and batch number of the vaccine 
must be recorded. 

The International Certificate of Vaccina 
tion or Revaccination against Yellow Fever 
was amended to extend the validity of the 
certificate from 6 years to 10 years. Cer 
tificates already in use are automatically 
extended to be valid for 10 years. 

Hospital Infection Kit Part II 
Now Available 

Part II of an information kit on con 
trol of hospital infections has been released 
by the Ontario Hospital Association. 

The material up-dates the work of the 
Canadian Council on Hospital Accredita 
tion, includes a comprehensive section on 
dietary department involvement, and in 
cludes new information on infection control 
in laundry departments. A copy of an in 
fection reporting form currently in use in 
a member hospital is attached. 

Part I of the material on infections con 
trol was prepared in July 1966 in response 
to needs revealed in the book The Control 
of Infections in Hospitals, by W. H. Le 
Riche, C. E. Balcom, and G. van Belle. 
The book reported on a survey of hospitals 
in Ontario and revealed problems in the 
areas of infection control. 

Since that time the Ontario Hospital As 
sociation has undertaken educational ser 
vices, including the publication of these 
kits, to acquaint members with the details 
of how an infection control program can 
be instituted. 

MARCH 1967 



news 



Cobalt Medications Withdrawn 
From Market 

The U.S. Federal Food and Drug Ad 
ministration in Washington announced in 
mid-January the removal from the market 
of medications with a cobalt base. These 
medications were used in the treatment of 
certain types of anemia. Manufacturers 
have complied with this decision pending 
the results of further studies on the ef 
fectiveness of the products. 

In Canada, the same medications were 
withdrawn from the market on December 
27th following deaths due to cardiac failure 
in drinkers of beer that had been made 
with cobalt salts. 

Quebec Interns and Residents 
Get Better Salaries 

The interns and residents of Quebec hos 
pitals, who had resorted to "study days" on 
January 3 1 and February 7 to back demands 
for better salaries, have accepted salary in 
creases offered by the provincial govern 
ment. 

Interns who were receiving $3,060 per 
year will get $3,770; final-year residents 
who received $5,160, will get $6,170 under 
the new agreement. 

The residents and interns, who had re 
fused several previous offers from the 
government, accepted the final offer on the 
condition that increases will be brought in 
line with those of their Ontario colleagues 
if the report of the Castonguay Commission 
has not been submitted by July 1, 1967. 

A commission under M. Claude Caston 
guay has been set up to inquire into health 
and social welfare in the province. The in 
terns group is preparing a brief for the 
Commission that will outline the grievances 
of the interns and residents, and which is 
intended to serve as a basis for future 
negotiations. 

U.S. Dermatologist Speaks Out 

Neither parents nor teenagers, but priv 
ate physicians, are "contributing most" to 
the increasing venereal disease problem in 
the United States. 

So says Arthur C. Curtis, M.D., Chair 
man of The University of Michigan s 
department of dermatology. 

In an editorial in the current University 
of Michigan Medical Center Journal, Dr. 
Curtis says incidences of infectious syphilis 
and gonorrhea are continuing to increase, 
although fewer private physicians are re 
porting cases to health departments. He 
further asserts that those suffering most are 
the nation s young people. 

MARCH 1967 



"Our children are our most important 
asset," points out Dr. Curtis. "We should 
do all we can to make them knowledgeable 
about those things that may harm them, 
and do all we can to make this information 
possible for them to obtain." 

Recommending more V.D. instruction in 
schools, Dr. Curtis says that by treating 
and not reporting, "we physicians in priv 
ate practice are the ones who are contribut 
ing most to this infectious venereal disease 
problem among our young people. By 
treating and not reporting, we are allow 
ing an infectious disease to increase each 



year and hence infect more and more 
young people." 

Dr. Curtis believes physicians should 
explain the serious nature of the problem 
with the patient, enlisting the patient s 
support in reporting the case. 

"Physicians who treat V.D. can be good 
epidemiologists but they don t have the 
time or the experience to seek out contacts." 

Every city, state or county health 
department has trained workers who are 
expert in finding infectious venereal disease 
and bringing it to treatment, Dr. Curtis 
explains. "Why don t we use them ?" 



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FLEET ENEMA s fast prep time obsoletes soap and 
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ordeal of injecting large quantities of fluid into the 
bowel, and the possibility of water intoxication. 
The patient should preferably be lying on the left side 
with the knees flexed, or in the knee-chest position. 
Once the protective cap has been removed, and the 
prelubricated anatomically correct rectal tube gently 
inserted, simple manual pressure on the container 
does the rest! Care should be taken to ensure that 
the contents of the bowel are completely expelled. Left 
colon catharsis is normally achieved in two to five 
minutes, with little or no mucosal irritation, pain or 
spasm. If a patient is dehydrated or debilitated, 
hypertonic solutions such as FLEET ENEMA, must 
be administered with caution. Repeated use at short 
intervals is to be avoided. Do not administer to children 
under six months of age unless directed by a physician. 
And afterwards, no scrubbing, no sterilisation, no 
preparation for re-use. The complete FLEET ENEMA 
unit is simply discarded! 

Every special plastic "squeeze-bottle" contains 4 /2 
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adult dose of 4 fl. oz. can be easily expelled. A patented 
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Each 100 cc. of FLEET ENEMA contains: 

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Sodium phosphate 6 gm. 

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THE CANADIAN NURSE 15 



news 



AMA Supports 
Nursing Salary Raise 

A "significant improvement in the in 
come of the registered nurse" was called 
for by delegates to the American Medical 
Association s recent biannual session. 

The House agreed with the Board of 
Trustees and AMA s Committee on Nur 
sing which supports the need for a signi 
ficant improvement in the income of the 
registered nurse. They recognize that there 
will be considerable variation in compen 
sation depending upon the prevailing local 
conditions, training, experience, and degree 
of delegated responsibility. 

The House also voted to continue to 
support in principle all current nationally 
approved educational programs for nurses. 
It noted that the American Nurses As 
sociation and the National League for 
Nursing have called for nursing education 
to take place in colleges and universities. 

Support for the nurses salary raise was 
also voiced in an editorial in the Decem 
ber 12 issue of The AMA News, a weekly 
newspaper published by the American 
Medical Association. The editorial said: 



"Overworked and underpaid nurses have 
been given support for better wages and 
working conditions by the House of Deleg 
ates of the AMA. 

"The House noted that the American 
Nurses Association in June adopted a 
national salary goal of $6,500 for registered 
nurses beginning practice. But the House 
agreed with the report of the Board of 
Trustees and the Committee on Nursing 
which questioned such a national salary 
goal, establishing a minimum rate of com 
pensation for the entire country. 

"A salary for registered nurses should 
be controlled by economics and the supply 
or demand in the part of the country 
where the nurse is employed. There is 
considerable variation in compensation 
depending upon the prevailing local condi 
tions, training, experience, and the degree 
of delegated responsibility. 

"The ANA s goal was adopted in the 
belief that low salaries seriously hamper 
efforts to recruit nurses and to keep nurses 
in practice. In an interview printed in the 
November 28 issue of The AMA News, 
Jo Eleanor Elliott, RN, president of ANA, 
said many nurses with current licenses are 
not working because it is not economically 
feasible. 

" As long as these inactive nurses keep 
their licenses current, there is a potential 
to alleviate the nurse shortage, she said. 



The ANA is making a major effort to at 
tract these inactive RNs back into nursing. 
But they must be given the proper motiva 
tion including better wages and working 
conditions to make it worth their while." 

Tooth Transplantation 
Possible 

A tooth that has grown in a wrong posi 
tion can now be extracted and transplanted 
according to a new method practiced by 
Swedish dentist Dr. Karl-Erik Thonner at 
the Stockholm County Clinic of Ortho 
dontics, Nasby Park, Sweden. While keep 
ing the tooth alive in the patient s own 
blood serum during surgery, Dr. Thonner 
has operated on some 30 patients with good 
results. 

"It was surprising even to us when we 
found out that this was possible," Dr. Thon 
ner says in a Stockholm newspaper inter 
view. "When we started, we used to give 
the tooth a root filling after it had been 
transplanted. Then we discovered that it was 
possible to keep the nerve functions alive in 
the patient s own blood serum during sur 
gery." 

Usually only 15 minutes are required to 
prepare the insertion of the tooth. It has, 
however, been possible to keep the tooth 
alive up to at least one hour, the doctor 
reports. The operation proper takes about 
an hour to perform. 



Facts about 

l\ *CF| Cf > !"*(] 



Turnover Rate 



Graph shows turnover rate of full-time general duty nurses in public general 
hospitals in Canada, 1964. The turnover rate is a ratio of leavers to stayers. 
In 1964, the turnover rate for full-time general duty nurses in public general 
hospitals in Canada was 61 percent. This means that the number of resignations 
during the year was more than one-half of the average number employed 
during the year. 



Source: Research Unit, 
Canadian Nurses 
Association, 1966 



Percent 
100 



80 



60 



40 



20 







1 

9 



10 
24 



25- 

49 



50- 
99 



100- 
199 



200- 
299 



300- 
499 



500- 1000 + 
999 



SIZE OF HOSPITAL ( Number of beds ) 



16 THE CANADIAN NURSE 



MARCH 1967 









Style No. 16845 



One day of walking down 
those long corridors... 
and standing on those 
cold, hard floors will tell 
you the importance of 
White Uniform Oxfords 
by Savage. 

Savage White Uniform Oxford shoes 
are made to take the strain off feet that 
walk and stand on hard floors day in, 
day out. They are expertly fashioned 
over well-designed lasts to give true 
comfort. Sanitized too for lasting fresh 
ness. And wearing White Uniform 
Oxfords by Savage doesn t mean you 



have to give up style for comfort. You 
get a choice of military or flat heels in 
a full range of sizes and widths. Sure 
you ll still be on your feet for hours every 
day. And the corridors won t be any 
shorter. But you ll find it much easier 
to carry on smiling in White Uniform 
Oxfords by Savage. 



WHITE UNIORMS 



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names 






Margaret Ellen Cam 
eron, a native of 
Winnipeg, Manitoba, 
recently assumed her 
f 1 ^" <SS new duties as execu 

tive director of the 
Manitoba Association 
of Registered Nurses. 
A graduate of the 
School of Nursing of 
the Winnipeg General Hospital, Miss Cam 
eron also holds both her baccalaureate 
and master of science degrees from Teachers 
College, Columbia University, New York. 
The new executive director has been 
active both in her profession and in various 
nursing organizations since the beginning 
of her career. She has held various posi 
tions in the United States including that of 
school nurse in Connecticut, instructor at 
St. Luke s Hospital, New York and as 
sistant director of the St. Luke s Hospital 
School of Nursing. 

Following her experience in the United 
States, Miss Cameron returned to her home 
town to become assistant director of nurs 
ing at the Winnipeg General Hospital. 
The following year she became director of 
nursing, a position she held until 1963. 
Prior to her present appointment, she serv 
ed three years as assistant administrator 
of the same hospital. 

Her membership in nursing organiza 
tions, both provincial and national, included 
the chairmanship of the education com 
mittee of the Manitoba Association of 
Registered Nurses. 

As executive director, Miss Cameron is 
"pleased to participate in an expanded 
program for the Manitoba Association of 
Registered Nurses," and looks forward "to 
working with my colleagues in its develop 
ment." 



Marie Fountain, born and educated in 
England, has been appointed administrative 
assistant (nursing) to Jean Milligan at the 
Ottawa Civic Hospital. 

Miss Fountain graduated from Central 
Middlesex Hospital School of Nursing and 
emigrated to Canada in 1957. Before mov 
ing to Ottawa in 1959 she worked at hos 
pitals in Welland, Ontario and Banff, Al 
berta. 

At the Ottawa Civic, Miss Fountain 
worked as a head nurse and administrative 
supervisor before obtaining a diploma in 
nursing administration and education from 
the University of Ottawa in 1963. She is 
presently completing her requirements for 
her B.Sc. degree at the University. 

18 THE CANADIAN NURSE 




Pearl G. Morcombe 

is the new public 
relations officer for 
the Manitoba Associa 
tion of Registered 
Nurses. 

Mrs. Morcombe 
graduated from the 
General Hospital 
School of Nursing, 
Port Arthur, Ontario and is presently fol 
lowing an extension course in executive 
administration at the University of Mani 
toba. 

Mrs. Morcombe brings an impressive 
background in both nursing and public rela 
tions to her new job. She spent three years 
in industrial nursing at MacDonald Air 
craft in Winnipeg. From 1 955 to 1958 she 
acted as. public relations and field services 
representative with the Manitoba Hospital 
Services Association in Winnipeg. From 
1958 to 1962 she was liaison officer for 
the Manitoba Hospital Commission. 

Prior to her new appointment Mrs. Mor 
combe spent five years as assistant to the 
manager of hospital construction for the 
Manitoba Hospital Commission. 

Wilhelmina Bell is 

the new director of 
nursing service at the 
General and Mar 
ine Hospital, Owen 
Sound. A graduate of 
the Royal Victoria 
Hospital School of 
Nursing in Montreal, 
Miss Bell subsequent 
ly studied nursing education at the Univer 
sity of Toronto and followed a postgraduate 
course on psychiatric nursing at the New 
York Psychiatric Institute. 

She gained experience in both nursing 
and nursing education in the United States 
and Canada. At the Presbyterian Hospital, 
New York, Miss Bell served as a head 
nurse. Following this she worked as an 
instructor and a clinical supervisor at the 
Wellesley Hospital, Toronto, and the St. 
Catharines General Hospital, St. Catharines, 
Ontario. 

Back in the United States, at Durham, 
North Carolina, Miss Bell worked as coor 
dinator for a school for colored practical 
nurses at Duke University School of Nurs 
ing. 

Prior to her present appointment at the 
General and Marine Hospital, Miss Bell 
was director of nursing service at the 
Public General Hospital, Chatham, Ontario. 





Diane Yvonne Ste 
wart, of London, On 
tario, received a 
double appointment 
recently from the 
London Health As 
sociation and the 
University of Western 
Ontario. She was ap 
pointed director of 
nursing service at the new University Hos 
pital and also an associate professor, part- 
time, in the University of Western Ontario 
School of Nursing. 

Miss Stewart obtained her B.Sc.N. from 
Western and is currently completing re 
quirements there for a master of science 
in nursing degree. A Canadian Nurses 
Foundation Fellowship was awarded to 
Miss Stewart for 1966-67. 

Following graduation from Victoria Hos 
pital School of Nursing in London, Miss 
Stewart attended the University of Toronto 
for one year. She then taught obstetrical 
nursing at the Victoria Hospital School of 
Nursing for two years. At that time she 
became a supervisor in the nursing service 
department and later assistant director of 
nursing at Victoria Hospital. 

Joanne Fyle, St. Thomas, Ontario, has 
been awarded the RNAO entrance bursary 
at McMaster University School of Nur 
sing. 

Sharon Hanna, Dunnville, Ontario, has 
won the Niemeier Scholarship for high 
standing in third year maternal and child 
care nursing. 

Elizabeth Latimer, Hamilton, Ontario, 
is winner of the McGregor Clinic Scholar 
ship for highset standing in third year 
medical-surgical nursing. 

Nancy Mcllwraith, Marathon, Ontario, 
has won the Niemeier Scholarship for 
highest standing in first and second year 
clinical nursing subjects. 

Irene Ash worth, 
former supervisor of 
the Ottawa Branch of 
the Victorian Order 
of Nurses, recently 
joined the national of 
fice staff as a regional 
supervisor. 

Miss Ashworth, a 
graduate of the School 
of Nursing of St. Joseph s Hospital, Hamil 
ton, Ontario, also holds a diploma in pub 
lic health which she earned in 1959 from 

MARCH 1967 




the University of Western Ontario and a 
diploma in supervision and administration 
from the University of Toronto. 

Before joining the Victorian Order of 
Nurses in 1957, Miss Ashworth did general 
and private duty nursing at the Hamilton 
Civic Hospital and St. Joseph s Hospital, 
Hamilton, Ontario. She served as a staff 
nurse with the Hamilton Branch of the 
V.O.N. until 1963. The following year she 
became supervisor of the Ottawa Branch 
where she remained until her present ap 
pointment as a regional supervisor. 

Lillian Mae Randall, a native of Van 
couver, British Columbia, also joined the 
national office of the Victorian Order of 
Nurses as a regional supervisor. 

Miss Randall graduated from the School 
of Nursing of the Vancouver General Hos 
pital in 1945 and served for one year as a 
staff nurse in the psychiatric ward of the 
same hospital. 

The following year she obtained her 
certificate in public health nursing from 
the University of British Columbia. 

In 1947 Miss Randall became a staff 
nurse for the Vancouver Branch of the 
V.O.N. , and later the educational super 
visor for the Vancouver Branch. 

In 1963 she obtained a certificate in 
public health administration and supervi 
sion from the University of Toronto. 

At the end of 1966, Margaret E. Mac- 
dona Id retired from service at the Calgary 
General, the hospital she entered as a 
student nurse over 40 years ago. 

Born in New Brunswick, Miss Mac- 
donald came to Western Canada in 1919 
and entered the Calgary General Hospital 
School of Nursing in 1923. After her grad 
uation in 1926, she began her career at the 
hospital. She gained experience as a staff 
nurse, private duty nurse, head nurse and 
nursing supervisor. 

At retirement she was evening supervisor 
in the convalescent-rehabilitation building 
of the hospital. 

Known affectionately as "Black Mac" 
since her school days, Miss Macdonald is 
"a person who always places others first." 
At the open house reception given in her 
honor before her retirement, Miss Mac- 
donald s 37 years of continuous service at 
the Calgary General Hospital were recogniz 
ed by members of the hospital board and 
medical staff. 

Florence Taylor, associate director of 
nursing education, Brantford General Hos 
pital since August, died suddenly Decem 
ber 19, 1966. 

Her nursing experience has taken her 
through Canada, the United States, India, 
Korea, and Manchuria. 

Miss Taylor joined the staff of Brant- 
MARCH 1967 




Enaam Abou-Youssef, an instructor from the United Arab Republic, discusses 
CNA s public relations program with June Ferguson, public relations officer. 



On the homeward swing of a journey 
that began in February 1961, Enaam Y. 
Abou-Youssef visited CNA House in Ot 
tawa, Wednesday, January 18, 1967. 

Miss Abou-Youssef, a nurse from the 
United Arab Republic, attended the Uni 
versity of California School of Nursing 
where she obtained her master of science 
degree in 1963. She then enrolled in the 
doctoral program at Teachers College, 
Columbia University in New York. 

Miss Abou-Youssef is from Alexandria, 
Egypt. In 1960, she was in the second 
class to graduate from the first university 
nursing course established in the UAR at 
the Higher Institute of Nursing, University 
of Alexandria. Following this she was ap 
pointed clinical instructor at the same 
institution. 

Miss Abou-Youssef said that the establish 
ment of university schools of nursing in 
the UAR brought "more prestige and sta 
tus" to the profession in her country. 

Miss Abou-Youssef is presently working 
on her doctoral project - - a thesis on 
maternity nursing "focused on the respon 



sibilities of the nurse to the family during 
the maternity cycle." She hopes that the 
thesis eventually will be translated into 
Arabic and published as a textbook to be 
used by the baccalaureate students in the 
Near Eastern Region. 

The book will be entirely new in its 
approach to maternity nursing as it does 
not include anatomy and physiology of re 
productive organs or the mechanism of labor 
as complete units. 

During her visits to the Universities of 
Manitoba and Western Ontario, Miss Abou- 
Youssef gathered ideas for developing a 
different point of view for the master s 
program to be inaugurated at the University 
of Alexandria. 

On her return home this spring she will 
teach maternity nursing at the Higher In 
stitute of Nursing. She is also involved 
in developing nursing activities, nursing 
education and nursing service throughout 
her country. 

Miss Abou-Youssef also admits she looks 
forward "to being waited on again" when 
she returns to her homeland. 



ford General Hospital, January 1966 as 
assistant director of nursing education. 

Canadian-born Helen Young, a widely 
known figure in American nursing, died 
recently at 92. 

Miss Young taught in an Ontario public 
school for 13 years before she entered the 
Presbyterian Hospital School of Nursing, 
New York, in 1909. In World War I she 
served at a hospital for the wounded in 
Juilly, France. 

In 1921, nine years after Miss Young 
became a nurse at the Presbyterian Hospi 
tal, she succeeded Miss Anna C. Maxwell, 
the school s first director. 



In 1933 Miss Young became the first 
editor of Quick Reference Book for Nurses, 
and in 1937 she received Columbia Uni 
versity s medal for excellence, awarded 
for service to the university. 

William A. Holland, administrator of the 
Oshawa General Hospital, was recently 
elected president of the Ontario Hospital 
Association for 1966-67. Mr. Holland has 
been a member of the Association s board 
of directors since 1959. As the first admi 
nistrator to hold the top OHA post in five 
years, Mr. Holland succeeds Glen W. Phelps, 
a trustee of the Orillia Soldier s Memorial 
Hospital. 

THE CANADIAN NURSE 19 




soft testimony to your patients comfort 

Your own hands are testimony to Dermassage s effectiveness. Applied by your 
soft, practiced hands, Dermassage alleviates your patient s minor skin irritations 
and discomfort. It adds a welcome, soothing touch to tender, sheet-burned 
skin; relieves dryness, itching and cracking . . . aids in preventing decubitus 
ulcers. In short, Dermassage is "the topical tranquilizer". . . it relaxes the patient 
. . . helps make his hospital stay more pleasant. 

You will like Dermassage for other reasons, too. A body rub with it saves your time 
and energy. Massage is gentle, smooth and fast. You needn t follow-up with 
talcum and there is no greasiness to clean away. It won t stain or soil linens or 
bed-clothes. You can easily make friends with Dermassage send for a sample! 

Now available in new, 16 ounce plastic container with convenient flip-top closure. 



L\, 




MEDICATED 






sihre refreshant and body massage 





20 THE CANADIAN NURSE 



LAKESIDE LABORATORIES (CANADA) LTD. 
64Colgate Aven ue Toronto 8, Ontario 

MARCH 1967 



in a capsule 



Wine - the Chemical Symphony 

"Have a glass of this therapeutic adju 
vant for the promotion of relaxation," your 
medically-minded host may suggest some 
evening after supper. If you refuse, you 
may be turning down a "natural tranquilizer" 
of some fine old vintage. 

For those who need and excuse to drink 
wine, Dr. SaJvatore P. Lucia, professor of 
medicine at the University of California 
School of Medicine, San Francisco, provides 
several sound therapeutic ones. 

Wine, he points out, has been used for 
more than 40 centuries as a safe tranqui 
lizer and there is no reason it should not 
be used for this even today. Modern re 
search has confirmed the age-old values of 
wine, he says. In his view, wine is a "natu 
ral tranquilizer" while tranquilizing drugs are 
"artificial tranquilizers." 

Wine, says Dr. Lucia, is more than merely 
alcohol. "Its many other ingredients bring 
it into the category of tranquilizers. Many 
studies of wine disclose that the ability of 
wine to reduce nervous tension is a result 
of the ability of its chemical symphony " 
Numerous studies have shown "that wine 
gives far more sustained and gently tran 
quilizing effects than does straight ethyl 
alcohol diluted with water to the same 
strength." 

One leading possibility for use of wine 
as a tranquilizer is in the elderly, says Dr. 
Lucia. It can help them "cope with... ten 
sions and live out a long span in peace and 
gratitude." One serving before a meal or 
two servings with a meal provide the desired 
tranquilization. 

"In the rush of rapid pharmaceutical pro 
gress, the ages-old established, inexpensive, 
and safe medicine called wine is apt to be 
forgotten," writes Dr. Lucia. "So, too, in a 
post-prohibition society, these ancient dietary 
beverages are still apt to be regarded over- 
emotionally and pseudo-moralistically by the 
physician. Yet, the long history of the use 
of wine in medical practice and the modern 
scientific research confirming its values are 
gaining the attention of increasing numbers 
of physicians." 



No Utopia for Nurses 

"In some Utopian tomorrow," says Mollie 
Gillen of Chatelaine, (January 1967) nurses 
will be "freed at last from the tyranny of 
counting sheets, serving meals, making up 
empty beds and pushing wheelchairs." 

Unfortunately, she sees that tomorrow as 
a far distant one. 

MARCH 1967 



The nursing profession in Canada today, 
according to Mrs. Gillen, is characterized 
by "creaking mechanisms and archaic pat 
terns" which, instead of improving are act 
ing as deterrents to prospective student 
nurses. 

In fact, the percentage of high-school 
graduates entering nursing has declined 
sharply over the past twenty years. Only 
10 percent of girls from high schools are 
enrolling today (in 1951 it was 20 percent; 
in 1944, 25 percent), and "a continued drop 
is feared unless nursing is made more at 
tractive as a career," she says. 

What exactly are the problems that beset 
nursing today? asks Mrs. Gillen. 

In answer to her own question, she places 
at the top of the list the shortage of nurses 
that keeps whole hospital wings closed and 
overworks existing staff. She also points out 
the shortage of teachers to train nurses and 
the proliferation of aides and helpers whose 
training and duties aren t clearly defined. 
Then there are antiquated hospital schools, 
where training is paid for by free labor. Not 
surprising, continues the author, is the grow 
ing demand for promotion opportunities in 
clinical nursing, as well as in administration 
and teaching. Moreover, the profession is 
beset by internal conflicts for better pay, 
better working conditions and a more de 
mocratic organization. 

Problems unfortunately are more plentiful 
and obvious than solutions. However, all 
Canadian provinces today at least recognize 
the need for shortening the diploma pro 
gram, for providing opportunities for clinical 
specialization, and for rearranging salary 
levels. 

"With solutions slowly being found to the 
still-quite-bitter intramural arguments within 
the profession... nursing could be at the 
beginning of a new regime that safeguards 
the nurses in their rights as well as the 
public in its expectation of good service," 
concludes Mrs. Gillen. 

5,500,000 Still Puffing 

At least 1,000,000 Canadians did it. An 
other 2,500,000 seriously tried but couldn t, 
and a further 3,000,000 didn t even attempt 
to break the smoking habit. 

Of the 1,000,000 regular cigaret smokers 
who successfully overcame the habit, most 
claimed "unspecified health reasons" as their 
reason for quitting. Others named coughing, 
throat irritation, bronchitis, family objec 
tions, expense, and doctor s orders as res 
ponsible. Low on the list came fear of 
cancer. 



Even those 5,500,000 brave Canadians 
who steadfastly hang onto the habit despite 
the odds, admit dissatisfaction with their 
smoking habits. These findings were the re 
sults of a survey recently released by Hon. 
Allan J. MacEachen, Minister of National 
Health and Welfare. 

The study also shows that certain pro 
vinces are more nicotine-prone than others. 
Regionally, British Columbia shows the high 
est proportion of former regular smokers 
(49% of male and 17% of female non- 
smokers and occasional smokers were at one 
time regular cigaret smokers) and Quebec 
the smallest (30% of male and 8% of 
female.) British Columbia also shows the 
highest proportion (53%) of regular cigaret 
smokers who have tried to stop smoking, 
and Quebec the lowest (37%). 

Conducted among persons 15 years of 
age and over, the survey reveals that among 
present non-smokers of cigarets, 32% of 
the men and 9% of the women at one time 
were regular users. Attempts to break the 
smoking habit tend to be more common 
among those under 40. Women who have 
succeeded are most commonly found in the 
20 to 39 age bracket. Men who have stopped 
daily smoking are more frequently found 
among those 40 and over. 

A growing awareness of the dangers of 
cigaret smoking is reflected in the concern of 
the Department of National Health and 
Welfare with the smoking habits of Cana 
dians. Annual surveys and comparisons of 
results are planned by the Department for 
the future. 



Vaccine Race 

A live vaccine against mumps appears 
to have been developed simultaneously - 
or almost simultaneously in the East and 
in the West. 

The Russians claim that the first one was 
developed at the Pasteur Institute in Lenin 
grad. This vaccine was tried out among all 
the children aged two to twelve in Pskov, a 
regional center nearby. There were only a 
few cases in the year following the vaccina 
tion, although there had been mass out 
breaks in the same region previously. 

In the U. S. a live attenuated vaccine 
(developed by Dr. Maurice R. Hillman and 
Dr. Eugene Buynak) was tested among 482 
Philadelphia school children. A great many 
cases of natural mumps occurred in the test 
community, whereas there were only two 
cases both in school-age youngsters 
among the vaccinated children. Royal 
Society of Health Journal Sept. -Oct. 

THE CANADIAN NURSE 21 



new products { 



Descriptions are based on information 
supplied by the manufacturer and are 
provided only as a service to readers. 



Specimen Container 

(PROFESSIONAL DISPOSABLE PRODUCTS) 
Description A water-tight and odor- 
proof, eight-ounce laboratory specimen 
container made of shatterproof, opaque 
plastic. This container is supplied with a 
specially imprinted lid which simplifies 
writing identifying information. 

For additional information, write to 
Professional Disposable Products, Inc., 22- 
28 South Sixth Avenue, Mount Vernon, 
New York 10550. 




Norlestrin 1 mg. 

(PARKE-DAVIS) 

Description A new, low-dosage (1.0 
mg.) form of the oral contraceptive, Norl 
estrin, previously available only as a 2.5 
mg. tablet. Each tablet of Norlestrin 1 mg. 
contains norethindrone acetate 1 mg. and 
ethinyl estradiol 0.05 mg. 

Norlestrin 1 mg. is a progestogen- 
estrogen combination for control of con 
ception. Like Norlestrin 2.5 mg., it contains 
norethindrone acetate and ethinyl estradiol 
but it contains only 1 mg. of the proges- 
togen. 

Dosage Initial cycle: The first tablet 
is taken on the fifth day after onset of 
menstruation. The first day of menstrual 
flow is considered day one. Tablets should 
be taken regularly with a meal or at bed 
time. After taking one tablet daily for 21 
consecutive days, no tablets are taken for 
7 days. Subsequent cycles: After the 7-day 
interval in which no tablets are taken, a 
new course of 21 tablets is started regard 
less of whether bleeding has finished or 
not. Each cycle consists of 21 days of 
medication and a 7-day interval without 
medication. 

Contraindications This type of ther 
apy (progestogen-estrogen combinations) is 
contraindicated in patients with, or with a 
history of, cancer (because of the estro 
gen), preexisting liver disease, or a history 

22 THE CANADIAN NURSE 



of thromboembolic disorder. Oral contra 
ceptives should not be used by nursing 
mothers, young women in whom epiphyseal 
closure is not complete, or women who 
have had a stroke, partial or complete loss 
of vision, diplopia or proptosis. The use of 
oral contraceptives containing progesta- 
tional agents should be avoided where preg 
nancy is suspected. 

Side Effects Break through bleeding, 
nausea, and diminished menstrual flow are 
the principal side effects considered to be 
drug related. 

For further information or to obtain the 
file booklet containing the basic prescrib 
ing information, write Parke, Davis & 
Company, Ltd., P.O. Box 2100, St. Laurent 
Post Office, Montreal 9, P.Q. 



Flexitone 

(CYANAMID) 

Description A new adjustable surgical 
binder for use with postoperative and post- 
partum patients. The Flexitone binder is 
designed to provide comfortable support 
without compromise of muscle tone. It will 
not roll, ride or chafe and provides enough 
"give" to allow freedom for the muscles to 
expand and contract. 

The binders are anatomically designed 
and sized for both male and female patients. 
They are lined for comfort and may be 
laundered repeatedly without loss of resi 
liency. 

Uses The Flexitone surgical binder is 
used after abdominal surgery, after normal 
delivery or caesarian section, for chest sup 
port in fractures and surgery, and for back 
support. 



. 



Cerevon-S 

(CALMIC) 

Description Cerevon-S is a combina 
tion of ferrous succinate 150 mg. and suc- 
cinic acid 110 mg. 



Indications Used in the treatment of 
iron deficiency anemia. Compared to 
other methods of treating iron deficiency 
anemia, Cerevon-S showed a more rapid 
rate of hemoglobin rise and a higher final 
hemoglobin level after twenty weeks. It is 
also effective in some patients who do not 
respond to conventional oral iron. 

Dosages - - One capsule t.i.d. between 
meals or as prescribed. When given be 
tween meals, the period of maximum ab 
sorption, Cerevon-S produces minimal intol 
erance, although gastrointestinal disturb 
ances, eg., diarrhea, constipation, heart 
burn, can occur. 

For further information, contact Calmic 
Limited, 16 Curity Avenue, Toronto 16, 
Ont. 



Ger-o-Foam 

(WINLEY-MORRIS) 

Description Benzocaine 3%, methyl 
salicylate 30%, in a neutralized emulsion 
base containing volatile oils. 

Indications Ger-o-Foam is an anesthe 
tic analgesic foam used to increase mobility 
of limbs in musculo-skeletal involvements. 

The formulation permits penetration of 
the medicaments into the deeper structures 
underlying the skin to relieve pain and 
stiffness in rheumatoid and osteoarthritis; 
painful limbs following cerebrovascular 
accident; painful healed fracture, low back 
pain; sprains; etc. 

Directions Apply to affected part 
and massage in gently. 

For information contact: Winley-Morris 
Co. Ltd., 2795 Bates Rd., Montreal 26, P.Q. 



Tussagesic 

(ANCA) 

Description - - Each time-release tablet 
contains triaminic 50 mg., dormethan 
30 mg., terpin hydrate 180 mg., and aceta 
minophen 325 mg. 

Indications For relief of symptoms of 
the common cold. Tussagesic decongests, 
relieves pain, breaks up cough and provides 
effective expectorant action. 

Dosages For adults and children over 
12 years one tablet, swallowed whole, 
in morning, mid-afternoon and at bedtime. 
Tussagesic is also available in suspension 
form. Both tablets and suspension can 
cause occasional drowsiness, blurred vision, 
cardiac palpitations, flushing, dizziness, 
nervousness or gastrointestinal upsets. 

For further information, contact ANCA 
Laboratories, 1377 Lawrence Ave., East, 
Toronto, Ontario. 

MARCH 1967 



dates 



April 27-29, 1967 

Registered Nurses Association of Ontario, 
annual meeting. Royal York Hotel, 
Toronto. 

May 4-6, 1967 

St. Boniface Hospital, School of Nursing, 

25th Reunion of the 1 942 Graduating 

Class. Would members of the 1 942 

graduating class please write to 

Miss F.E. Taylor, R.N., 

I 0123-122 Street, Edmonton. 

May 8-12, 1967 

National League for Nursing, Biennial 
Convention. Theme: "Nursing in the Health 
Revolution." New York Hilton Hotel, 
New York City. 

May 16-19, 1967 

Alberta Association of Registered Nurses 
Annual Meeting, Chateau Lacombe, 
Edmonton, Alberta. 

May 19-21, 1967 

60th Anniversary reunion of the Royal 
Inland Hospital School of Nursing, 
Komloops, B.C. For further information 
write: Mrs. Sylvia Lum, Suite "C", 
248 Victoria St., Kamloops, B.C. 

May 24-26, 1967 

Saskatchewan Association of 
Registered Nurses Annual Meeting. 
Saskatoon. 

May 24-26, 1967 

International Symposium on Electrical 
Activity of the Heart, London, Ontario. 
For further information write to 
Dr. G.W. Manning, Victoria Hospital, 
London, Ont. 

May 29-31, 1967 

Operating Room Nurses Fourth Ontario 
Conference, The Inn on the Park, 
Toronto, Ont. Sponsored by the Operating 
Room Nurses of Greater Toronto. Direct 
inquiries to: Mrs. Eleanor Conlin, R.N., 
437 Glen Park Avenue, Apt. 309, 
Toronto )9, Ont. 

May 31-June 2, 1967 

Registered Nurses Association of Nova 
Scotia Annual Meeting, Sydney, N.S. 

May 31-June 2, 1967 

Registered Nurses Association of British 
Columbia Annual Meeting, Bayshore Inn, 
Vancouver, B.C. 

MARCH 1967 



May 31-June 2, 1967 

New Brunswick Association 
of Registered Nurses Annual 
Meeting. The Playhouse, Fredericton. 



June 4-16, 1967 

University of Windsor, 6th annual 
residential summer course on alcohol and 
problems of addiction. Co-sponsored by 
the University of Windsor and the Alcohol 
and Drug Addiction Foundation of Ontario. 
Limited enrollment. Enquiries to: Director, 
Summer Course, Addiction Research 
Foundation, 24 Harbord St., Toronto 5, Ont. 



June 5-8, 1967 

Atlantic Provinces Hospital Association, 
Annual Meeting. 



June 8-9, 1967 

Manitoba Association of Registered 
Nurses Annual Meeting to be held 
in connection with the Western Regional 
Hospital Conference 



June 12-15 1967 

Canadian Dietetic Association, 32nd 
Convention, Chateau Laurier, Ottawa. 



June 18-21, 1967 

Ottawa Civic Hospital, Centennial Home 
Coming. Alumnae or former associates of 
the Ottawa Civic Hospital who are 
interested in the program should write to: 
Executive Director, Ottawa Civic Hospital. 



June 24, 1967 

St. Joseph s Hospital School of Nursing, 

Toronto, Centennial Reunion. Any graduates 

who do not receive alumnae newsletters, 

please send name and address to: 

St. Joseph s Hospital School of Nursing 

Alumnae, 30 The Queensway, Toronto 3, 

Ontario. 



July, 1967 

75th Anniversary, Nova Scotia Hospital 
School of Nursing, Dartmouth, N.S. All 
interested graduates please contact 
Mrs. G. Varheff, 20 Ellenvale Ave., 
Dartmouth, N.S. 



September 15-17, 1967 

70th Anniversary, Aberdeen Hospital School 
of Nursing, New Glasgow, Nova Scotia. 
Write: Mrs. Allison MacCulloch, R.R. #2, 
New Glasgow, Pictou Co., Nova Scotia. 



NEW FOR HOSPITALS 

the 
Autolope 

It responds 
to heat 
treatment. 




When the contents of the enve 
lope are completely sterilized by 
the Autoclave, the indicator ink 
changes colour. This unique Gage 
Autolope is security folded and 
pressure-sensitive gummed to 
prevent contamination. It was de 
veloped for Autoclaving with the 
help of medical, paper, printing, 
adhesive, and chemical experts. 
The Autolope is available now in 
an approved range of sizes. An 
other new envelope idea from . . . 



Envelope Division 

4BVMH 

GAGE 




The Company that 

enjoys the business it s in. 

Envelopes Stationery -Textbooks 

TORONTO MONTREAL VANCOUVER 
WINNIPEG KINGSTON BRANTFORE 

THE CANADIAN NURSE 23 



Plan Now For 



Basic Sciences 

BASIC PHYSIOLOGY AND ANATOMY 

By Ellen E. Chaffee, R.N., M.N., M. Lin.; and Esther 
M. Greisheimer, Ph.D., M.D. 

Physiology and anatomy are skillfully fused in this text 
designed for the freshman nursing student. Realistic 
clinical applications clarify scientific principles. Chap 
ters are amplified by summaries and questions. Testing 
program for instructors use is available upon request. 
656 Pages 371 Illustrations, 45 in color, plus Videograf 
1964 $7.75. 

LABORATORY MANUAL IN 
PHYSIOLOGY AND ANATOMY 

By Ellen E. Chaffee, R.N., M.N., M. Lin. 
Organized into twenty-four laboratory units with em 
phasis on the normal human body. Practical applica 
tions animate the principles. Study questions follow 
each lesson. 260 Pages Illustrated 1963 $2.60. 

PHYSIOLOGY AND ANATOMY: 
With Practical Considerations 

By Esther M. Greisheimer, Ph.D., M.D.; with the 
assistance oj J. Robert Troyer, Ph.D. 
A text designed to meet the needs of students in general 
courses as well as those directly applied to nursing. 
Physiology and anatomy are featured in separate chap 
ters according to body systems. Content is enlivened 
by practical considerations pertaining to broad health 
problems. 894 Pages 430 Illustrations, plus Videograf 
8th Edition, 1963 $9.50. 

ESSENTIALS OF CHEMISTRY 

By Gretchen O. Luros, M.A.; and Jack C. Towne, 
Ph.D. 

Provides the student with a strong foundation in inor 
ganic, organic and particularly physiologic chemistry. 
New data incorporated in the 7th Edition includes car 
bohydrates, lipids, proteins, metabolism, nucleic acids, 
enzymes, vitamins, inorganic body requirements and 
hormones. 356 Pages 101 Illustrations 7th Edition, 
1966 $6.50. 

INTRODUCTION TO MEDICAL PHYSICS 

By J. Trygve Jensen, Ed. D. 

A clarification of the physical principles underlying 
nursing procedures and an explanation of the scientific 
framework upon which qualified nursing activities de 
pend. Virtually all the basic laws of physics employed 
in nursing are discussed. 240 Pages 139 Illustrations 
1960 Paperbound $3.75. 

BASIC MICROBIOLOGY 

By Margaret F. Wheeler, R.N., A.M.; and Wesley A. 
yolk, Ph.D. 

A clear and concise introduction to the basic aspects 
of microbiology. Coverage includes: discussions of 
bacteria, protozoa, viruses, rickettsiae and other micro 
organisms and their relevance to health and disease. 
Pathogens are grouped according to portal of entry, 
in relation to body systems. Chapter summaries, ques 
tions, illustrations and charts contribute to overall 
clarity. 389 Pages 163 Illustrations 1964 $6.25. 



NUTRITION IN HEALTH AND DISEASE 

By Lenna F. Cooper, Sc.D.; Edith M. Barber, M.S.; 
Helen S. Mitchell, Ph.D., Sc.D.; and Henderika J. Ryn- 
bergen, M.S.; with the assistance of Jessie C. Greene, 
B.S. 

Because of vigorous streamlining, this book has gained 
in versatility both as a text for basic nutrition courses 
and for diet therapy. The 14th Edition includes up-to- 
date tables, bibliography, and an expanded glossary. 
615 Pages 101 Illustrations 14th Edition, 1963 $7.50. 

Clinical Nursing 

SCIENTIFIC FOUNDATIONS OF NURSING 
(Formerly Science Principles Applied to 
Nursing) 

By Madelyn T. Nordmark, R.N., M.S.; Anne W. Roh- 
weder, R.N., M.N. 

To bridge the gap between scientific theory and clinical 
practice. This book should be in every student s hands. 
It is an indispensable tool for problem solving, nursing 
diagnosis, intervention, and review. About 250 Pages 
2nd Edition, 1967 Paperbound, about $5.00 Cloth- 
bound, about $7.00. 

FUNDAMENTALS OF NURSING: 

The Humanities And The Sciences In 
Nursing 

By Elinor V. Fuerst, R.N., M.A.; and LuVerne Wolff, 
R.N.,M.A. 

This text is designed to give the student a sound under* 
standing of the principles underlying all nursing action. 
The problem-solving approach is stressed to enable 
the student to act flexibly and analytically in any given 
situation. Emphasis is on "core" content common to 
every area of nursing practice. 661 Pages 158 Illustra 
tions 3rd Edition, 1964 $6.50. 

PROGRAMMED MATHEMATICS OF 
DRUGS AND SOLUTIONS 

By Mabel E. Weaver, R.N., M.S.; and Vera J. Koehler, 
R.N., M.N. 

Shows the student step by step how to apply her 
basic knowledge of mathematics to the administration 
of drugs and solutions. The 1966 Printing contains a 
chapter on medications for infants and children. 109 
Pages 1966 Printing Paperbound, $2.25. 

FUNDAMENTALS OF MEDICATIONS: 
Dosages, Solutions and Mathematics 

By Joy B. Plein, Ph.D.; and Elmer M. Plein, Ph.D. 

Uniquely keyed to current nursing practice, this new 
text-workbook for Pharmacology I includes: sources 
of drugs, dosage forms, routes of administration, 
mathematics of drug administration, medication orders, 
pediatric dosages and legislation regulating the use of 
drugs. About 125 Pages New, 1967 Paperbound, about 
$3.50. 



Fall Classes 



CARE OF THE ADULT PATIENT: 
Medical-Surgical Nursing 

By Dorothy W. Smith, R.N., Ed.D.; Claudia D. dps, 
R.N., Ed.D. 

Extensively rewritten, this patient-centered textbook is 
more valuable than ever to the instructor and student. 
Relevant concepts from the life sciences have been 
integrated throughout the text. New nursing principles 
and practices created by medical progress have been 
included. 1206 Pages 406 Illustrations 2nd Edition, 
1966 $11.25. 

TEXTBOOK OF MEDICAL-SURGICAL 
NURSING 

By Lillian Slioltis Brunner, R.N., M.S.; Charles Phillips 
Emerson, Jr., M.D.; L. Kraeer Ferguson, M.D., 
F.A.C.S.; and Doris Smith Suddarth, R.N., M.S.N. 

This comprehensive textbook of nursing care provides 
a wealth of information and an intelligent understand 
ing of every patient regarding altered physiology, signs 
and symptoms, management of his condition and 
problems, appreciation of emotional state and rehabili 
tation. 1198 Pages 509 Illustrations, 48 in color 1964 
$12.50. 

PATIENT STUDIES IN MEDICAL- 
SURGICAL NURSING 

By Jane Secor, R.N., M.A . 

Twenty-six patient studies focus on patients as persons 
who have major medical or surgical problems, and who 
require creative nursing care. The author skillfully 
interweaves ethics, the hospital milieu, legal implica 
tions, interpersonal relationships, psychosocial aspects, 
and the family. About 400 Pages New, 1967 Paper- 
bound, about $5.25. 

BASIC PSYCHIATRIC CONCEPTS 
IN NURSING 

By Charles K. Hofling, M.D.; Madeleine M. Leininger, 
M.S.N. , Ph.D.; and Elizabeth A. Bregg, R.N., B.S. 
Advances in psychiatry with implications for increased 
nursing responsibilities are reflected in this new edition. 
Problem-solving, process recording and short and 
long-term nursing goals are stressed. Nurse-patient in 
teraction is clarified by patient studies. Helpful sum 
maries follow each chapter. About 575 Pages 2nd Edi 
tion, 1967 About $7.00. 

PATIENT STUDIES IN MATERNAL 

AND CHILD NURSING: 

A Family-Centered Student Guide 

By Ann L. Clark, R.N., M.A.; Hella M. Hakerem, 
R.N., M.A.; Stephanie C. Basara, R.N., M.A.; and 
Diane A. Walano, R.N., M.A. 

Designed for integrated maternal-child nursing courses, 
this book also correlates effectively where obstetrics 
and pediatrics are taught separately. Realistic patient 
situations enable the student to identify the nursing 
needs of mothers and children and to plan nursing 
action based on her knowledge of the sciences. 305 
Pages 1966 Paperbound, $5.00 Clothbound, $7.25. 



MATERNITY NURSING 

By Elise Fitzpatrick, R.N., M.A.; Nicholson J. East 
man, M.D.; and Sharon Reeder, R.N., M.S. 

Family-centered throughout, the 1 1th Edition has been 
brought completely up-to-date. "This is the book for 
which we have been waiting," writes one instructor, 
"it is readable, the illustrations are excellent, and the 
family-centered approach is of infinite value." 638 
Pages 311 Illustrations llth Edition, 1966 $8.00. 

ESSENTIALS OF PEDIATR1C NURSING 

By Florence G. Blake, R.N., M.A.; and F. Howell 
Wright, M.D. 

Offers the student a rich source of material on all 
phases of the nursing of children, i.e., how to recog 
nize, understand, appreciate and meet the emotional, 
physical and social needs of the child. Presented ac 
cording to age levels from birth to adolescence. 815 
Pages 237 Illustrations 7th Edition, 1963 $8.00. 

FOUNDATIONS OF PEDIATRIC NURSING 

By Violet Broadribb, R.N., M.S. 

A "shorter" presentation, confined to the cardinal prin 
ciples involved in the nursing of children. In this new 
text the author provides commonsense guidance and 
specific suggestions for nursing action. Content is struc 
tured according to age groups. About 600 Pages 1967 
Paperbound, about $5.00 Clothbound, about $7.50. 

For Senior Seminars 

SOCIAL INTERACTION AND 
PATIENT CARE 

Edited by James K. Skipper, Jr., Ph.D.; and Robert C. 
Leonard, Ph.D. 

This well-researched book of readings serves as a link 
between the social sciences and clinical practice. Its 
35 articles, accompanied by editorial commentary, deal 
with the nurse s role, communication, the patient s 
view, structural and cultural environment, and role 
conflicts. 400 Pages 1965 Paperbound $4.75. 

PROFESSIONAL NURSING 
Foundations, Perspectives and 
Relationships 

By Eugenia K. Spalding, R.N., M.A., D.H.L.; and 
Lucille E. Natter, R.N., Ed.D. 

This text presents the student with the essential final 
step in the process of evolving into an independently 
thinking and acting professional person, with a broad 
view of the traditions, trends, opportunities and chal 
lenges of nursing. 684 Pages 75 Illustrations 7th Edi 
tion, 1965 $8.50. 




60 FRONT STREET WEST, TORONTO 1, ONTARIO 



Katherine E. MacLaggan 



A Trihnte Katherine E. MacLaggan, president of the Canadian Nurses Association, 

and director of the School of Nursing, University of New Brunswick, died 
February 6, 1967, in Saint John, New Brunswick. 

Her death brings to an end a career that provided outstanding leadership in 
Canadian nursing. 

Dr. MacLaggan was born in Fredericton, N.B., and received her early 
education and preparation as a teacher in that city. Becoming interested in 
nursing, she entered the School of Nursing of the Royal Victoria Hospital, 
Montreal, and graduated in 1943. Following this, she enrolled in the McGill 
School for Graduate Nurses and obtained a diploma in public health nursing in 
1945. Two years later she returned to the same institution to complete require 
ments for the degree of bachelor of nursing. 

In 1957 she obtained a master of arts degree from Teachers College, 
Columbia University, and in 1965, a doctor of education degree from the same 
university. 

Dr. MacLaggan s professional experience includes staff positions at the 
Royal Victoria Hospital, in industry, and in the public health nursing service 
of the New Brunswick Department of Health. Prior to her appointment as the 
first director of the University of New Brunswick School of Nursing in 1958, 
she was assistant director of public health nursing in the province and a faculty 
member of Teachers College, Fredericton. 

Some nurses will remember Katherine MacLaggan as a capable, humanistic 
practitioner of nursing. Others will remember her as a superb teacher, an able 
administrator, an understanding counselor, and a gentlewoman of great integrity, 
courage, and strength of purpose. 

Many nurses of today and of future generations will remember Katherine 
MacLaggan for her perceptive observations and sound recommendations 
concerning nursing education. Her brilliant dissertation Portrait of Nursing: 
A Plan for the Education of Nurses in the Province of New Brunswick, in 
which she lucidly and forcefully set forth her philosophy of nursing and nursing 
education, has already provided a goal for educators in her native province. It 
is being examined with interest by educators in other provinces. 

Those who knew Katherine MacLaggan well, will remember her as a person 
first, and as a nurse second. She gave much of herself to many. She was never 
too busy to listen to a colleague s problems over a cup of coffee, or to take a 
visitor on a guided tour of her home city, Fredericton, of which she was so 
proud. 

In her Acceptance Address as newly-elected President of the Canadian 
Nurses Association last July, Dr. MacLaggan stated: "You have a right [as 
CNA members] to demand that your president has integrity, will offer a leader 
ship subject to guidance, and will make decisions and bear the consequences...." 

This integrity she had. This leadership she gave. 

The President continued: "Our conflict no longer concerns the problems 
themselves; it concerns the status quo versus change. It is a delusion to think 
that change can be avoided... The luxury of delay has disappeared. I ask you 
to provide, on every occasion, what is necessary to the implementation of an 
idea whose time has come. 

"If decisions, or policies, or laws, or persons prove to be inadequate to the 
ongoing scheme of things, remember that these are not forever and can be 
changed at the next time of decision taking. What remain forever are: intellectual 
honesty, values, courage, action and results." 

This was her philosophy. 

26 THE CANADIAN NURSE MARCH 1967 





MARCH 1967 



THE CANADIAN NURSE 27 



Telegrams Expressed Grief 



Immediately following the untimely death of (Catherine E. MacLaggan, 
President of the Canadian Nurses Association, many expressions of sympathy 
were received at National Office. 



From individuals 

"Our sympathy and prayers go out to you ... at this 
sad time. Katherine s great contribution to nursing in 
Canada will remain always a tribute to her name. 
Penny Stiver." (Former Executive Director, Canadian 
Nurses Association.) 

"... I share your sorrow. At the same time, I asso 
ciate myself with wider groups in nursing nationally and 
internationally, in grateful tribute to Katherine E. Mac- 
Laggan s magnificent contribution in leadership, vision, 
and courage. Dorothy Percy, Ottawa." (Former Chief 
Nursing Consultant, Department of National Health and 
Welfare.) 

"To the nurses of Canada, deepest sympathy on the 
great loss in death of your President. Lucy D. Ger 
main, Assistant Director, Pennsylvania Hospital, Phila 
delphia." (Former Executive Director of the American 
Journal of Nursing Company.) 

From hospital and university staff 

"On behalf of all nursing staff ... we convey . . . our 
profound regret at the loss of Dr. Katherine E. Mac 
Laggan, our National President. We were keenly aware of 
and proud of her professional stature. For those now 
entrusted with providing continuity for the task to which 
she brought such distinction, we offer our deepest sym 
pathy and support. - - Helen D. Penney, Director of 
Nursing, Central Newfoundland Hospital, Grand Falls, 
Nfld." 

"Sincere condolences on the death of Dr. Katherine E. 
MacLaggan, CNA President. Miss R. Cunningham, 
Director, School of Nursing, St. Paul s Hospital, Van 
couver, B. C." 

"Please accept our sincere condolences on the death 
of our Association President, Dr. Katherine E. MacLag 
gan. Faculty, Misericordia School of Nursing, Win 
nipeg, Manitoba." 

"The Faculty and Students . . . extend ... to the Can 
adian Nurses Association their sincere sympathy in the 
loss of one who has contributed so much to nursing. 
Lillian Brady, Director of Nursing Education. Halifax 
Infirmary School of Nursing, Halifax, N.S." 

"Personnally and on behalf of the nursing staff of 
the University of Alberta Hospital, I extend sincere 
sympathy. M. Geneva Purcell, Director of Nursing. 
University of Alberta Hospital." 

"The board and staff . . . express their sympathy to 
the Canadian Nurses Association in the death of their 
president, Dr. Katherine E. MacLaggan. Director of 
Nursing. Moose Jaw Union Hospital, Moose Jaw, Sask." 

"Very sensitive to your loss. Sympathy and prayers. 
- Sister Franchise Robert and Faculty, School of Nurs 
ing, University of Ottawa." 

From government personnel 

"We join the nurses of this and other countries in 
28 THE CANADIAN NURSE 



paying tribute to Katherine MacLaggan. We join her 
friends and family in gratitude for her life and in sorrow 
for her death. Our sincere sympathies. Senior Nursing 
Officers of the Department of National Health and 
Welfare." 

"The Deputy Minister and Officials of the Department 
of Health join me in extending to you . . . sincere con 
dolences on your great loss. - - Stephen H. Weyman, 
M.D., Minister of Health, Province of New Brunswick." 

"Most sincere regrets from administrative and nursing 
staff on death of Dr. Katherine E. MacLaggan. Her 
efforts in the field of nursing will exert a lasting influence 
in Canada and internationally. - - O.H. Curtis, M.D., 
C.M., D.P.H., Deputy Minister of Health, Province of 
Prince Edward Island." 

From associations 

"Sincere condolences . . . Katherine MacLaggan was a 
great lady and a distinguished leader in Canadian nurs 
ing. President and Members, Association of Nurses 
of the Province of Quebec." 

"Our heartfelt sympathy on the death of Dr. Kathe 
rine E. MacLaggan. Nurses of the Labrador City 
Wabush Chapter, Labrador." 

"Deeply regret to learn of the death of your Presi 
dent. Dr. Katherine MacLaggan was a most dedicated 
educator and leader. Her presence will be surely missed. 
Chaiker Abbis, President, Canadian Hospital As 
sociation." 

"Regret untimely passing of Katherine E. MacLaggan 
who made unique contribution to nursing education and 
the national organization. M.T. MacFarland, M.D., Re 
gistrar, College of Physicians and Surgeons, Winnipeg, 
Manitoba." 

"The deepest regrets of our Association on the death 
of your President. W.C. Sinnott, Secretary, Hospital 
Association of Prince Edward Island." 

"The ANA grieves with you over the untimely death 
of Katherine E. MacLaggan, well known to us for her 
forward-looking and progressive leadership in nursing. 
We extend our deepest sympathy with the sad realiza 
tion that your loss is our loss too. Judith G. Whitaker, 
Executive Director, American Nurses Association, New 
York." 

"Deepest sympathy to the Canadian Nurses Associa 
tion and to all Canadian nurses on the death of Presi 
dent Katherine E. MacLaggan. Am notifying ICN mem 
ber associations. Sheila Quinn, Deputy Executive 
Director, International Council of Nurses, Geneva, Swit 
zerland." 

"The members of the Association of Nurses of Prince 
Edward Island share with you at CNA Headquarters 
a great personal loss in the early death of our President, 
Dr. Katherine E. MacLaggan. Helen L. Bolger, 
Executive Secretary Registrar, ANPEI." 

MARCH 1967 



Medical care of 
Eskimo children 

Small northern hospitals now have something new a pediatric resident. 



The disparity in health standards bet 
ween the Arctic and southern Canada 
has prompted a committee of the Cana 
dian Pediatric Society to study the 
Eskimo health problems, and to make 
suggestions as to how pediatricians can 
cooperate with and support the pro 
grams presently being carried out by 
the Northern Health Services of the 
Department of Health and Welfare. As 
a result, in July of 1965, The Montreal 
Children s Hospital started to send a 
senior pediatric resident each month 
to serve in the new 28-bed hospital at 
Frobisher Bay, Baffin Island. 

A harsh land 

The health problems of the arctic 
must be considered in relation to the 
geography, climate, and the history of 
its people. The 1,253,000 square miles 
of land comprising the Northwest Terri 
tories equal the combined area of the 
Atlantic Provinces, Quebec, Ontario, 
and Manitoba. Distance alone creates 
a problem in survival. In the Eastern 
Arctic (Baffin and Ellesmere Islands) 
Precambrian rocks form mountains, 
often divided by glaciers, which rise to 
10,000 feet and fall in spectacular 
cliffs into majestic fjords. The vegeta 
tion consists only of lichens, mosses 
and a few shrubs. 

In this land, the dog sled or skidoo 
is useful only on the coastal areas 
during the winter. Effective transporta 
tion of men and materials depends on 
the airplane in winter, and on coastal 
vessels during the short summer. 

MARCH 1967 



N. Steinmetz, M.D. 

During break-up and freeze-up most 
transportation comes to a standstill, 
although some of the larger settlements 
have landing strips on firm soil. Radio 
is still the chief means of communica 
tion. 

The climate makes severe demands 
on housing and clothing. Great skill is 
required to live off the land. Between 
November and February it is genuinely 
cold, the temperature falling to minus 
30-40 degrees F, and only in June, 
July and August does the average tem 
perature rise to 40-45 degrees F. Strong 
winds and blowing snow are the chief 
hazards in overland travel. 

A hard life 

Traditionally, all the Eskimos lived 
along the coast in family units, and 
moved to follow the game upon which 
their survival depended. Starting as 
early as 1000 A.D., but mainly between 
the sixteenth and eighteenth centuries, 
they had increasing contact with white 
explorers. During the 1800 s they dealt 
with whalers, fur traders, and mission 
aries. Gradually they settled near 
trading posts as the latter developed, 
and sought employment there. The 
white man established these settlements 
according to criteria that satisfied his 
own requirements. 

The town of Frobisher Bay, for ex 
ample, was never an Eskimo settle- 

Dr. Steinmetz is pediatric resident at The 
Montreal Children s Hospital, and particip 
ated in the program at Frobisher Bay. 



ment. In 1914 the Hudson Bay Com 
pany established a trading post else 
where on the Bay. In 1942, the United 
States built a military airfield in Fro 
bisher, obviously because it was a good 
place to have an airfield, not because 
the area was a good hunting ground. 
Of the approximately 3,000 Eskimos in 
the Eastern Arctic, nearly one-half of 
them now live in Frobisher Bay, which 
is for them an artificial location. Here, 
as in other such settlements, the men 
find little opportunity to use their 
special skills for hunting and arctic 
survival. Consequently these skills are 
as foreign to the new generation as 
they are to us. The Royal Canadian 
Mounted Police now teach Eskimo 
Boy Scouts how to make igloos. 

Education, as we know it, is now 
being provided to children, but the 
percentage of the population over 15 
years of age without schooling is re 
markably high - - 34 percent in the 
North West Territories compared with 
1.4 percent in the rest of Canada. 1 The 
birth rate is more than twice that of 
the rest of Canada; the under-four- 
years age-group comprises the largest 
group of the Eskimo population in the 
Eastern Arctic. Hence the interest of 
Canadian pediatricians in improving 
the medical care of these people. 

Pediatric care essential 

The economic situation is such that 
a bare, prefabricated, one-room dwel 
ling (4 walls, 1 roof, 2 windows) costs 
$1000, a gallon of fuel oil costs 60tf, a 

THE CANADIAN NURSE 29 





30 THE CANADIAN NURSE 



gallon of water 1<. The per capita 
income of the northern Eskimo is $426 
per year compared to $1,734 for the 
rest of Canada. 2 Under these conditions 
it is difficult to build an environment 
conducive to good health. Diseases that 
could be prevented by education, im 
proved living standards, and accessibili 
ty of treatment still take a huge toll in 
life. 

The task of providing effective me 
dical care to this scattered population 
is presently being attempted by the 28- 
bed Frobisher Bay Hospital under three 
doctors, by the 28-bed missionary 
hospital in Pangnirtung, which is staffed 
by three very able nurses, by several 
nursing stations, and by lay dispensers 
in small outposts. 

The infant death rate per 1000 live 
births is 6 l /2 times that for the rest of 
Canada, and the death rate for children 
one to four years of age is 15 times 
that for the rest of Canada. 3 

Death Rates for Infants Under 1 Year 
of Age -- Per 100,000 Live Births. 4 
NWT P.Q. Canada 
Lower Respiratory 
Tract Infection 5458 473 434 
Gastroenteritis 1463 153 120 

The death rate of female children 
is significantly greater than that for 
males. 

Three out of five children are born 
at home, delivered by women who have 
learned the art from their ancestors. 
Pre-and postnatal care, as we know it, 
is difficult to provide for such a far- 
flung population. 

Simple diseases have serious effects 

Among the greatest causes of death 
in infants under one year of age are 
lower respiratory tract infections and 
gastroenteritis, each 12Vi and 12 times 
as common as in the rest of Canada/ 
These figures all look very dramatic, 
but it must be remembered that they 
have to be interpreted with care, due 
to the small number of the population. 

The Eskimos living on the trading 
post no longer have easy access to 
their native diet, and cannot afford nor 
know how to choose a balanced diet 

MARCH 1967 



from the variety of foods available in 
the white man s stores. All too often 
potato chips and soft drinks form a dis 
proportionate amount of their pur 
chase. As a result malnutrition is mani 
fested by the appearance of vitamin D 
deficiency, rickets, and iron deficiency 
anemia. These diseases are not seen in 
the more remote camps where raw 
meat is the staple diet 

Impetigo, upper respiratory tract in 
fections, and draining ears are common 
place. Our experience suggests that in 
the Eastern Arctic there is a relation 
ship between middle ear disease and 
social conditions, as was demonstrated 
by Cambon et al 8 in the Western 
Arctic. 

Several epidemics of viral disease 
have been recorded. 7 They have been 
more severe in remote areas than in 
more concentrated populations where 
immunological resistance is higher. 
With this in mind, a widespread pro 
gram of measles vaccination has re 
cently been undertaken by the Northern 
Health Service. 

Memophilus influenza and meningo- 
coccal meningitis have been reported 
to occur more frequently than in the 
rest of Canada. In Frobisher Bay we 
have seen five to seven cases per month 
whereas the average from a much larger 
population at The Montreal Children s 
Hospital is 4.4 cases per month. Poor 
housing, inadequate nutrition in settle 
ments, and resulting decreased resistan 
ce are likely contributory causes. 

Chronic disease is common 

The increasing influx of transient 
laborers has been associated with a 
rising incidence of venereal disease in 
adolescents. 

Routine chest roentgenograms of 
Eskimo children referred to The Mon 
treal Children s Hospital for various 
reasons have frequently demonstrated 
a diffuse chronic non-tuberculous lung 
disease. Clinically, the child may or may 
not cough, and sometimes no adventi 
tious sounds are heard on auscultation. 
The significance of these findings is 
not known, nor is the cause or course. 

Tuberculosis has been a problem in 
the Eskimo population only since the 

MARCH 1967 



second half of the 1800 s, when con 
tact with whalers, trappers, and traders 
became established. As late as 1955-57 
Schaefer 8 estimated that 5-10 percent 
of all Eskimos reached by the Eastern 
Arctic Patrol had to be evacuated for 
treatment of active tuberculosis. A vi 
gorous program of BCG vaccination, 
case finding, and treatment is reducing 
this problem. 

A new frontier 

The government departments dealing 
with Canada s northland have made 
great strides in recent years in improv 
ing living and health standards of the 
Eskimo, and in providing education 
and training. However, much remains 
to be done. In the same spirit in which 
other Canadian university centers have 
initiated medical services in the North,* 
so The Montreal Children s Hospital is 
sending its residents to Frobisher Bay. 
Here they are responsible for those 
children requiring special medical care, 
and as a result are often able to reduce 
evacuations for treatment. 

The residents run two well-baby 
clinics a week, and work in the out 
patients department every afternoon. 
An important aspect of their work is 
the provision of follow-up care to those 
children who have returned from The 
Montreal Children s Hospital after 
having been treated there. Thus, com 
munication between the two hospitals 
has improved greatly. We hope that by 
complementing the work of the North 
ern Health Service, their presence will 
improve the medical care of Eskimo 
children. 

The project has already proven its 
worth as a training experience by de 
monstrating how much can be achieved 
far away from a sophisticated medical 
center. Residents are more intimately 
involved with the family and the child s 
home. Much interest in the medical 
problems of the Arctic is already being 

*Queen s University, Kingston, Ont., sends 
interns to Moose Factory in Northern On 
tario, and the University of Alberta pro 
vides intern service for the Inuvik area at 
the mouth of the Mackenzie River in the 
Northwest Territories. 



stimulated as a result of this contact. 

In summary, we "Southerners" have 
been responsible for disturbing the 
ecology of the Arctic. We have tempted 
the Eskimo with our way of life, and 
made him dependent on our technolo 
gy. As these programs of medical 
service mature, we hope they will help 
to restore the new generation to better 
health. This done, the Eskimo will be 
able to benefit from the training and 
education that can equip him to parti 
cipate in our civilization. 

References 

1. The Northwest Territories Today. A re 
ference paper for the Advisory commis 
sion on the Development of Govern 
ment in the Northwest Territories. Ot 
tawa, Queen s Printer, 1965, p. 18. 

2. Ibid., p. 123. 

3. Ibid., p. 19. 

4. Dominion Bureau of Statistics. Vital 
Statistics 84-202 (1960) Ottawa, Queen s 
Printer, 1962. 

5. Ibid. 

6. Cambon, K., Galbraith, J.D., and Kong, 
G. Middle Ear Disease in Indians of 
the Mount Currie Reservation, British 
Columbia. CMAJ, 93: 1301, 1965. 

7. Schaeffer, Otto, Medical Observations 
and Problems in the Canadian Arctic. 
CMAJ, 81: 248, 1959. 

8. Ibid. D 



THE CANADIAN NURSE 31 



Nursing in 
the North 






Nursing on Canada s modern-day 
frontier offers a wide variety 
of experience and numerous 
opportunities. Nurses are essential 
in bringing a health program 
to the vast northern area of 
Canada where geography is the 
single greatest enemy of health. 



Health care to the more than 200,000 
residents scattered over 3,500,000 square 
miles of territory is provided by the 
Medical Services Branch of the Department 
of National Health and Welfare. 



Over 800 nurses, working in hospitals or 
from nursing stations and health centers 
located in trading posts and settlements, 
meet the challenge of providing 
comprehensive, community-type health 
programs even such programs 
as managing your first two-wheeler. 





The northern nurse s responsibilities include 
communicable disease control; 
immunization programs; health supervision 
and teaching through home visits, 
child-health, pre- and postnatal clinics; 
and health consultant in home, 
school and community. 



This 28-bed hospital at Frobisher Bay 
is one of 16 hospitals maintained 
by the Medical Services Branch. 





32 THE CANADIAN NURSE 



MARCH 1967 




The hospitals conform to federal standards 
and are built in accord with the north s 
special needs. They are well-equipped and 
are far from primitive. 



Outpost nursing stations, 42 of them, are 
located in isolated areas that have no 
resident physician. Two nurses, one well- 
qualified in obstetrical nursing, and one 
with public health preparation, staff 
these centers for emergency care and 
evacuation of the seriously ill. 



Visiting nurses work mainly from health 
clinics in semi-isolated centers. The nurse 
in the north travels by any means available: 
plane, canoe, dog-team, fishing boat, 
and, where there are roads, car. 



School health is one aspect of the total 
community program. The nurse and teacher 
work together to strengthen home and 
school health. 










Winter working dress for the public health 
nurses includes a native parka and ski 
outfit. A new uniform is being made up 
and will include a dress suit, topcoat, 
slack outfit, and ski suit. D 



MARCH 1967 



THE CANADIAN NURSE 33 



Outpost nursing 



A new program at Oalhousie University helps prepare nurses for positions in 
remote areas of the North. 



During the last half-dozen years, the 
School of Nursing and the Medical 
School at Dalhousie University have 
become aware that nurses serving in 
the remote, sparsely populated areas 
of Canada s Northland are required to 
provide care far beyond the horizons 
defined by nursing education in Cana 
da. Dr. Robert C. Dickson, Professor 
of Medicine at Dalhousie University 
Medical School, and others have had 
opportunity for travel and observation 
in the Canadian North, and a liaison 
has developed between the University 
and one organization providing north 
ern health services. 

Everywhere in the North the provi 
sion of health services tends to follow 
one general pattern. Regional hospitals, 
preferably with several doctors, are 
surrounded by satellite nursing stations 
staffed by one or more nurses. Trans 
portation, usually by air, is provided 
from the satellite nursing station to the 
regional hospital when weather condi 
tions permit, and some sort of radio 
communication is maintained between 
them. 

The nursing stations vary in size and 
facilities offered, but they serve as a 
center for the health program through 
out the surrounding district, providing 
outpatient clinics at the nursing station, 
a few beds for inpatients, and a public 
health program. A midwifery service is 
provided, and there are beds and 
bassinets in the station for obstetrical 
patients. Initial care for seriously ill 
patients awaiting transport to the re- 

34 THE CANADIAN NURSE 



Ruth E. May, B.A., R.N., CM. 

gional hospital is given in the station, if 
possible under the radio direction of a 
doctor at the nearest hospital. 

A lack of doctors 

It is obvious that a nurse at a 
northern nursing station will be pro 
viding services which fall within the 
prerogative of a doctor in other parts 
of Canada. Although a doctor may 
visit from time to time and be available 
for some radio consultation, many of 
the nurse s day-by-day activities will 
require judgment and skill beyond the 
scope of what we normally consider 
to be nursing. 

It is impossible to provide doctors 
now at this level; there are simply not 
enough available. Moreover, a familiar- 
Miss May is the newly appointed Lecturer 
in Outpost Nursing at the Dalhousie Uni 
versity School of Nursing. She holds a B.A. 
degree from Wellesley College, Wellesley, 
Mass., and is a graduate of the Massachu 
setts General Hospital School of Nursing 
in Boston. She received her midwifery 
preparation at the Frontier Nursing Service 
Graduate School of Midwifery in Kentucky, 
and has served for a number of years with 
the International Grenfell Association in 
northern Newfoundland and Labrador. For 
the past eight years she has been nurse- 
in-charge of the nursing station and sur 
rounding district at Mary s Harbour, Labra 
dor, an area in which about 1500 Labra 
dor fishermen live. Miss May has also been 
a member of Nurses Christian Fellowship. 



ity with this type of service leads one 
to feel that doctors should not be used 
at this grass roots level even if they 
were available. The total population 
served by one of these stations is small 
and often widely scattered. There is 
little to attract a doctor professionally. 
Diagnostic facilities are of necessity 
very limited in a station of this size. 
Any surgery requiring general anesthe 
sia, no matter how minor, is usually 
not possible as there is normally no one 
qualified to give anesthesia safely. A 
very large number of the doctor s pa 
tients would need to be referred to the 
regional hospital, often not because the 
doctor lacked the medical background 
to care for them, but because the re 
quisite facilities would be lacking. 

Is it reasonable, one asks, for a per 
son educated amid all the intricacies of 
latter twentieth century medicine to 
work where it is impossible for him to 
use a considerable portion of the know 
ledge he has acquired and where 
further professional growth is neany 
impossible ? How much better for him 
to serve as a member of a medical 
team at a regional hospital and for 
specially prepared nurses to continue 
to serve at the nursing station level. 

As a familiarity with northern facil 
ities developed, one fact became in 
escapable. A large number of the 
nurses serving in northern nursing sta 
tions are either foreign born or foreign 
educated. This pattern developed es 
sentially because it was desirable for 
these nurses to have formal preparation 

MARCH 1967 



in midwifery, and such preparation is 
difficult to obtain on this side of the 
Atlantic. Gradually a conviction arose 
that facilities should be provided in 
Canada to help Canadian girls wishing 
Jo_work in remote areas of the North. 
We hear much these days about the 
responsibility of the highly developed 
nations to the developing areas of the 
world and the personal rewards of this 
"Peace Corps" type of service. Why 
not a plan to prepare Canadian nurses 
for service in the isolated areas of the 
Canadian North, a plan which would 
include preparation not only in mid 
wifery but in all the areas where the 
nurse is required to function beyond 
the scope of nursing elsewhere in 
Canada. 

A new program is born 

Thus the Outpost Nursing Program 
at Dalhousie was born. The entire fac 
ulty of the School of Nursing and 
key persons at the University Medical 
School have been most enthusiastic. A 
program extending over two calendar 
years has been planned and will be di 
rected by a member of the University 
School of Nursing faculty who is a 
qualified midwife with an extensive 
background of northern service at the 
nursing station level. 

The first class, to be admitted in 
September, 1967, will be limited to 
eight students, as the clinical experience 
will be highly individualized with in 
tensive tutorial type teaching maintain 
ed in all areas. Applicants must be 
graduate nurses and are asked to have 
completed at least one year of pro 
fessional nursing experience. Prepara 
tion in public health nursing, a vital 
area in northern service, will be inte 
grated throughout the program, and a 
university diploma in public health 
nursing as well as a diploma in outpost 
nursing will be awarded at the comple 
tion of the program. Within the next 
year or two a shortened course for 
students who already have preparation 
in public health nursing will be devised. 

Students will spend their first year 
in Halifax. Lectures and seminars in 
basic public health nursing will be 
provided during this year and also 
clinical teaching within the areas of 
general medicine, surgery, pediatrics, 
and midwifery. Some lectures in ma- 
teria medica and some basic laboratory 
experience will be included. Three 
teaching hospitals in Halifax have of 
fered clinical resources most enthu 
siastically for the students, and 
clinical teaching and experience will 
be carried out there, primarily at 
the bedside, under the direction of 
medical school personnel working in 
cooperation with the lecturer in outpost 
nursing. Opportunity will be given for 

MARCH 1967 



the student to develop some skill in 
basic physical examination and also in 
various specific procedures such as the 
starting of intravenous infusions, su 
turing, and the opening of superficial 
abscesses. 

The second year will consist of an 
internship under the direction of the 
University in a northern setting, using 
selected hospitals and nursing stations 
of the International Grenfell Associa 
tion and the Department of National 
Health and Welfare. The students will 
spend half of this year exclusively 
within the area of midwifery at St. 
Anthony Hospital, St. Anthony, New 
foundland. The remainder of the year 
will provide further teaching and su 
pervised experience in public health 
nursing and in clinical medicine, sur 
gery, and pediatrics. Opportunity will 
also be given for the students to de 
velop some skill in routine dental 
extractions. 

Midwifery emphasized 

Particular care has been given to the 
development of the midwifery section 
of the program. A comprehensive nine- 
month experience has been arranged 
with three months during the first year 
in Halifax and the remainder during 
the internship year. Lectures will be 
given by the lecturer in outpost nursing 
and the obstetrical staffs of the hospi 
tals involved. 

Each student will have the opportu 
nity to care for in labor, and to deliver, 
approximately 30 to 40 women. Op 
portunity to evaluate, follow, and con 
tribute to the care of patients with 
abnormal courses will be provided. 
There will be extensive experience in 
antenatal clinics with emphasis on 
patient and family teaching. During the 
internship, when travel permits, there 
will be a program of weekly home 
visits to mothers and babies following 
discharge from hospital. 

Experience in postpartum care and 
management of the normal newborn 
and premature infant will be provided. 
As in all the clinical areas, teaching 
and supervision will be individualized 
on a tutorial pattern. 

This experience will use as a found 
ation the three months in obstetrical 
nursing that students receive in their 
basic nursing education program. Al 
though basic obstetrical nursing is not 
midwifery, it does serve as a very useful 
background, and some lectures review 
ing and expanding this material will be 
given before the students embark on 
their full-time midwifery experience. 

At the end of the program, there 
fore, the students will have completed 
a total of one year within the overall 
area, three months during the basic 
nursing course, and nine months during 



the outpost nursing program. This has 
been arranged to be equivalent not 
only in time but also in content with 
the British pattern of midwifery pre 
paration, and the University feels that 
graduates of the program can be ex 
pected to function at the same level of 
competence. It is hoped that the esta 
blishment of this experience will re 
present a significant achievement in the 
history of nursing education in Canada. 

Constant emphasis throughout the 
entire program will be given to the 
early recognition and evalution of sig 
nificant illness and potential threats 
to the well-being of the patient and his 
family. The nurse must learn to initiate 
treatment or transfer the patient to a 
hospital before an emergency situation 
develops; one of her aims must be to 
prevent the development of emergency 
situations in isolated nursing stations 
whenever this is possible. However, 
there will be discussions of reasonable 
plans of action in unavoidable or un- 
predicted emergencies when medical 
aid or transport to hospital is not im 
mediately available. 

Considerable thought has been given 
to the identification of those functions 
and procedures that can be taught 
safely to nurses and to those that she 
should avoid. It is essential that the 
students be taught to recognize and 
respect their limitations. It should be 
noted, also, that it is never intended 
for these students to use the specific 
skills developed within this program in 
other areas of Canada where such care 
is provided by resident doctors. 

Arduous, but rewarding 

The type of northern service for 
which this program in outpost nursing 
seeks to prepare nurses is arduous, and 
nurses considering service of this sort 
should face the demands realistically. 
There are likely to be emergency 
situations and tragedies that must 
sometimes be met and accepted alone. 
Many of the common amenities of 
twentieth century living will be lacking. 
There can be periods of drudgery and 
loneliness; in due time the glamor is 
likely to fade. However, those who 
have steeped themselves in this work 
have found the rewards far outweighing 
the demands. There will always be a 
tremendous challenge and satisfaction 
in attempting to provide the best 
possible service to those whose birth 
right has included so much less than 
ours. 

Hundreds of years ago Jesus said to 
a group of his friends, 

"In so far as you rendered such 
services to one of the humblest of 
these my brethren, you rendered 
them to myself." Matthew 25: 
40, (Weymouth). D 

THE CANADIAN NURSE 35 



Drug dependency research 
expensive luxury or necessary 
commodity? 



In drug dependency research, the questions are still more 
plentiful than the answers. 



Mood-changing drugs and their 
effects on those who ingest them have 
received much attention during the 
past few years. Drugs hold a special 
fascination they at once attract and 
repel. Purveyors of juicy newspaper 
headlines, spicy television programs, 
lurid tales, are guaranteed a market. 
However, whatever sensational quali 
ties drugs may have, only serious study 
will enhance our knowledge to the 
point where fact rather than fancy will 
prevail. 

Research, for the most part, is not 
sensational. Unless some spectacular 
scientific breakthrough is achieved, it 
does not merit newspaper headlines. 
It is often forgotten that behind each 
striking discovery are years and years 
of quiet and often frustrating research 
and experimentation. Serendipity is 
indeed rare! 

Fortunately, more and more quali 
fied researchers are now studying 
mood-changing drugs and their physio 
logical, pharmacological, psychological 
and sociological effects. To be sure, 
one meets the very people who are part 
of interesting tales told, but the collec 
tion of factual data is an expensive, 
time-consuming and, at times, very 
tedious process. Nor are research re 
ports recommended bedtime reading 
unless perhaps for quick sleep induce 
ment. For research into drug depen 
dency must embrace such mundane 
matters as prevention, pharmacology, 
epidemiology, treatment, and legisla 
tion, and must assure a systematic ac- 

36 THE CANADIAN NURSE 



Ingeborg Paulus 

cumulation of general knowledge. It 
therefore has to draw on various dis 
ciplines to make it less of a riddle to 
those engaged in preventing and fight 
ing a disease that seems to take on new 
shapes as more and more mood- 
changing drugs become known and 
available for experimentation. 

NAF research program 

The Narcotic Addiction Foundation 
of British Columbia (NAF) was found 
ed in September, 1955, with the objec 
tive "to develop a research, treatment, 
rehabilitation and education program." 
Many obstacles prevented the develop 
ment of all goals simultaneously. Con 
sequently it was not possible until the 
end of 1964 to start the development 
of a research program. 

Research should include a thorough 
examination of the many-faceted as 
pects of drug dependency and abuse. 
Lack of financial resources have, to 
date, prevented the NAF from doing 
other than rudimentary medical and 
sociological research. We have been 
engaged in sociological research for 
two years. Some projects are finished, 
some are in progress, and some are in 
the planning stages. The following is 
a short account of research undertaken 
by the NAF. 



Miss Paulus is Research Associate with 
the Narcotic Addiction Foundation of British 
Columbia, Vancouver, B. C. 



Past endeavors 

Information Collection on the NAF 
Patient Population 

Any research calls for the accumu 
lation of a body of data that lends 
itself to manipulation. That is, if data 
are to be meaningfully interpreted they 
must be complete rather than frag 
mentary; they must be ordered into 
some meaningful categories rather than 
be a haphazard mess; and they must 
be accurate. The collection of this kind 
of data is not always easy. It is further 
complicated when the respondent is 
a patient who quite often comes for 
help only when he is drugged, agitated, 
or in the process of withdrawal; in 
other words, when his reasoning and 
memory frequently are impaired. 

This, then, was a first task: to 
devise a suitable form for collecting 
necessary information during the intake 
process, which would provide up-to- 
date knowledge of our patient popula 
tion. Data on socioeconomic character 
istics such as age, sex, marital status, 
education, etc., are now easily checked. 
We can get immediate information on 
our patients origin, period of addic 
tion and criminal record, accumulated 
either prior or subsequent to addiction. 
Apart from knowing something about 
the NAF treatment population, this 
kind of information is used to devise 
prevention and treatment methods. 

Treatment Results 

One of the primary functions of the 
staff at the NAF is to treat and reha- 

MARCH 1967 



bilitate its patients. How do we know 
whether or not our methods actually 
produce the desired results? One way 
is to compare two similar groups - 
one following a specific treatment 
program, the other not. After a suitable 
time lapse, the two groups can be 
followed up and the effects of treat 
ment measured and assessed. The re 
sults of such a study may be inconclu 
sive, yet they may give clues to success 
ful treatment approaches. Unfortun 
ately, this type of prospective treatment 
assessment study is time-consuming. It 
may be five or six years before suffi 
cient data are available for drawing 
conclusions that can be generalized 
over a larger population. Moreover, 
ethical considerations may prevent this 
type of research. Is one justified to 
treat some patients and not others? 
What criteria for selection should one 
employ? These are very serious ques 
tions that the treatment team must 
answer before such a study can be 
started. 

Retrospective follow-up studies are, 
at best, compromises. One has a group 
of patients treated some years ago; to 
find out what has happenned to these 
patients since their treatment is diffi 
cult, since the necessary controls are 
lacking. If a considerable number of 
patients had improved, one would not 
be justified in attributing this to the 
treatment, for other factors, including 
time, may have been equally important 
in bringing about a change. 

At the NAF we were faced with a 
unique situation. In 1963, Dr. R. Halli- 
day, past clinical director, decided to 
change the drug addiction treatment 
radically from that usually practiced in 
North America, by maintaining selected 
patients on small doses of metha- 
done for anywhere from 4 to 52-1- 
week periods. At the same time the 
NAF continued treating a portion of 
its patients by giving them regular, 
12-day withdrawals, in conjunction 
with the standard social work, psy 
chiatric, and medical treatment given 
to all patients. 

We could compare the two treatment 
populations and assess results, but we 
could not assess the effectiveness of 
either type of treatment. Since one 
treatment was quite different from any 
practiced during the past 40 years, we 
decided to do a retrospective follow-up 
study. As expected, the results of the 
study were inconclusive, but they did 
give an impetus to planning a long- 
range prospective study. Without the 
retrospective study, we might not have 
learned anything. By doing it, we 
gained at least enough knowledge to 
guide us in the future. 

Briefly, the study suggested that 
older patients responded more favor- 

MARCH 1967 



ably to either type of treatment. Age 
seemed to be the most important vari 
able, influencing change in a positive 
direction. For patients over 50 years 
of age, in particular, the prolonged 
methadone treatment program indi 
cated promising results.* 

From what we were able to learn, 
we concluded that the NAF is serving 
the community by maintaining all pa 
tients over 50 years on a narcotic 
drug. It seems that various processes 
(to be investigated shortly) take place 
in addicts lives that can best be de 
scribed as "maturing-out of narcotic 
addiction" (a term coined by Dr. Char 
les Winick, director, program in drug 
dependence and abuse of the American 
Social Health Association). But these 
processes seem to fail for a consider 
able portion of the addict population. 
This portion seems to be unable to 
function without some chemical help. 
To offset the detrimental aspects of 
the illegal procurement of drugs, a 
maintenance-treatment program seems 
an economical choice. As yet, we do 
not know what kind of treatment is 
indicated for younger addict patients. 
We feel that only new experimental 
approaches will help us further. 

Present research 

Barbiturates 

During the past few years, we have 
noted several changes in drug abuse 
patterns. First, increasingly more 
heroin addicts are using barbiturates, 
either alone or in conjunction with 
their heroin or methadone intake. We 
noted a rapid increase in barbiturate 
consumption especially among women. 
We postulated various hypotheses for 
this change in drug abuse patterns, 
which we were testing on a sample of 
our patients. The major hypothesis that 
the supplementation of heroin with 
barbiturates is mainly an economic 
necessity was confirmed. Furthermore, 
the easy availability of barbiturates also 
contributes to their heavy abuse. 

We know that the abuse of barbitur 
ates and amphetamines is not limited 
to heroin addicts. Unfortunately, our 
resources do not allow us to undertake 
an investigation into these drug abuses. 
A strong necessity for research into this 
problem exists, but it is fraught with 
difficulties. The result is that very few 
accounts other than "popular press" 
articles are available to bring this 
serious abuse, with its detrimental phy 
sical and social consequences, to the 

* Ingeborg Paulus, "A comparative Study 
of Long-term and Short-term Withdrawal of 
Narcotic Addicts Voluntarily Seeking Com 
prehensive Treatment," Vancouver, B. C., 
The Narcotic Addiction Foundation of 
British Columbia, April, 1966. 




THE CANADIAN NURSE 37 




attention of an uninformed public. 

Psychedelics 

At the present time, there seems to 
be an insatiable demand for accounts of 
the dangers and delights associated 
with the marijuana (cannabis saliva) 
and LSD-25 (lysergic acid diethylamide) 
cult. As expected, the popular press 
has taken the lead in "informing" the 
public about this cult. Speculations and 
half-truths fill page after page. Factual 
research is time-consuming, and before 
responsible findings are released, the 
myths surrounding these drugs seem to 
overshadow the realities. It becomes 
increasingly difficult, even for the wary 
researcher, to separate fact from fancy. 

The NAF study is especially interest 
ed in distinguishing between the drug 
abuser and the isolated young ex 
perimenter. It seems to be part of the 
follies, and perhaps the privileges of 
youth, to taste some of the forbidden 
fruits of life. Thus we are trying to 
determine who the young people are 
who are so attracted to psychedelic 
drugs that they risk incarceration and 
a criminal record just to partake of 
these forbidden "pleasures." 

We must ask such questions as: Will, 
in a few years from now, our clinic be 
overrun with narcotic drug users who 
started on their road to addiction via 
the psychedelics? Or will the use of 
psychedelics be a fad with no direct 
consequences as far as our future treat 
ment population is concerned? Will 
this group of drug abusers need treat 
ment at all? Or will it need treatment, 
but different from that required by the 
heroin addict? In other words, we are 
trying to find present facts on which 
to base future actions and policies. 

Planned research 

From our past endeavors we are 
perhaps able to answer some questions; 
but our questions are still more plenti 
ful than our answers. 

Prospective Treatment Follow-up 
Study 

One issue to be investigated, which 
arose out of the retrospective follow- 
up study, is the effectiveness of the 



38 THE CANADIAN NURSE 



present treatment the NAF is able to 
give. The retrospective follow-up study 
could not answer this question, because 
we had no untreated population as a 
control. It did, however, enable us to 
formulate a treatment-research pro 
gram. The proposed study will be very 
expensive; therefore, its realization is 
dependent on financial support present 
ly being sought. 

Natural History of Addiction 

A less expensive but no less impor 
tant project involves the investigation 
of the natural history of addiction. By 
questioning the addict and from ac 
cumulated records, we want to dis-- 
cover: who the addict was before he 
started to use drugs; the deciding fac 
tors that made him experiment with 
any kind of drug; the unpleasant re 
alities he was trying to escape; what 
happened once he started to use drugs; 
the length of the drug-use span; and 
what made him stop using drugs. In 
other words, what does an addict 
career entail? Does it come to a natural 
or unnatural end? And, once ended, 
what then? 

Goal: Prevention of abuse 

When we have answered some of 
these questions, we might be able to 
launch a more effective campaign of 
drug abuse prevention. This, we feel, 
merits our greatest efforts. Although it 
is essential to know how best to treat 
addicts, it is much more essential and 
also less expensive to prevent drug ex 
perimentation and abuse. The com 
petition for tax-payers dollars to 
prevent and cure society s various ills 
is heavy. The more we learn how to 
prevent these ills, the more funds will 
be available to enrich all of our lives. 

It may seem that in view of the pres 
sing demands for treatment, research is 
an expensive luxury; but viewed in the 
light of its long-term benefits, research 
is one of the most necessary commodi 
ties when dealing with the riddle of 
drug dependency and abuse. D 



MARCH 1967 



Use of narcotics 
in addict therapy 



Treatment of persons addicted to narcotics is frequently a dismal failure. The 
question of the role of narcotic drugs in the treatment of such persons 
still remains unanswered. 



For some years there has been con 
siderable controversy as to the validity 
or even morality --of using nar 
cotic drugs in the treatment and reha 
bilitation of narcotic drug addicts. To 
many people the concept that addicts 
can be treated or cured appears naive, 
or even ludicrous; follow-up statistics 
from various treatment centers are 
quoted to indicate that the vast major 
ity of addicts following treatment, in 
or out of prison, quickly relapse to 
their former way of life, that is, to 
criminal behavior or prostitution, as 
well as to the use of narcotic and other 
addicting drugs. 

On the other hand, there are those 
who commend what they term the 
"British system" of treating addicts. 
They conclude that the relatively small 
number of addicts in Britain (about 
753 according to the British Ministry 
of Health report, 1965) 1 is due to this 
supposed method of treating addicts 
there. When compared with Canada s 
known addict population of 3,573 in 
1965, 2 (in a population of 20 million 
as compared with Britain s population 
of more than 50 million) it may seem 
that there is something about the legal 
and medical management of addicts in 
Britain that we in Canada might study 
and adopt to our advantage. 

No "system" in Britain 

When one takes a closer look at the 
situation in Britain, a number of facts 
become apparent. First, there is in 
reality no "system" of treating addicts 

MARCH 1967 



Robert Halliday, M.B., D.P.M. 

in Britain if, by system, one means: 
that all addicts are given narcotics 
regularly in the course of treatment; 
that the government has clinics to 
which addicts may go for treatment; 
or that all drug addicts are registered 
and, once registered, are automatically 
placed on a narcotic for an indefinite 
period, or even for life. 

Further, when one considers the law 
relating to the manufacture, sale, dis 
tribution, and use of narcotics or dan 
gerous drugs, it becomes apparent that 
British law is very similar to Canadian 
law. 

From whence, then, comes the myth 
of the "British system"? for myth it 
is. In fact, there is no system of regis 
tration; nor are there government 
clinics; nor is it government policy (via 
the ministry of health or elsewhere) to 
encourage or direct physicians to treat 
addicts with narcotics. Indeed, in the 
British Ministry of Health report re 
ferred to earlier, the following recom 
mendations, among others, are made: 
that all addicts to dangerous drugs be 
reported to a central authority; that to 
treat addicts a number of special treat 
ment centers should be established, es 
pecially in the London area; and that 
it should be a statutory offence for doc 
tors (other than those on the staff of 
the special treatment centers) to pres 
cribe heroin and cocaine to an addict. 

Dr. Halliday is Co-ordinator of Education 
for the Narcotic Addiction Foundation of 
British Columbia, Vancouver, B.C. 



These recommendations make it quite 
clear that the "British system," so 
lauded by many nai ve, if well-meaning 
people, is not a reality. 

Addiction considered an illness 

What does happen in Britain that is 
different from typical Canadian policy 
and practice? As far back as 1924, the 
Rolleston Committee, which investi 
gated the problem of narcotic drug 
abuse for the British Government, c6n- 
cluded that morphine or heroin might 
properly be administered to addicts in 
the following circumstances: 

1. Where patients are under treat 
ment by the gradual withdrawal 
method with a view to cure. 

2. Where it has been demonstrated 
after a prolonged attempt at cure that 
the use of the drug cannot be safely 
discontinued entirely, on account of 
the severity of the withdrawal symp 
toms produced. 

3. Where it has been clearly de 
monstrated that the patient, while 
capable of leading a useful and rela 
tively normal life when a certain mini 
mum dose is regularly administered, 
becomes incapable of this when the 
drug is entirely discontinued. 

A memorandum from the British 
Ministry of Health to physicians in 
cluded this statement: "The continued 
supply of drugs to a patient, either 
direct or by prescription, solely for 
the gratification of addiction, is not 
regarded as a medical need." 3 

It may be concluded that one signif- 

THE CANADIAN NURSE 39 



leant difference between the British 
and Canadian attitudes toward addicts 
is that in Britain addicts have been 
recognized as people in need of medical 
help, whereas in Canada and the U.S., 
until recently, the addict has been re 
garded as a criminal, and treated as 
such. 

It was only in 1961 that Canadian 
legislation regarding illegal possession 
of narcotics was altered, and the man 
datory six months minimum jail sen 
tence of convicted persons revoked. 
This jail sentence was never mandatory 
in Britain. Usually fines, suspended 
sentences, or probation were employed, 
rather than imprisonment. 

Athough certain addicts notably 
the so-called criminal addicts are 
normally reluctant to enter hospital for 
treatment, the fact is that in Canada it 
is almost impossible to obtain a hos 
pital bed (general or psychiatric) for 
such therapy. In Britain it has usually 
been easier for the addict to gain ad 
mission to and obtain treatment in a 
hospital. Again, the emphasis has been 
on the addict as a sick and dependent 
person, whatever his criminal activities 
may be. 

In Canada today 

The first recommendation of the 
Rolleston Committee (now 40 years 
old) is generally accepted in Canada 
today. In most instances the synthetic 
narcotic methadone hydrochloride is 
used in the withdrawal program. It has 
been demonstrated that over a period 
of from one to three weeks, most nar 
cotic addicts (heroin being their drug 
of choice) can be safely withdrawn by 
gradually reducing the methadone 
which is substituted for the heroin. 

Since heroin cannot be legally ob 
tained for any purpose in Canada, it 
cannot be used, though morphine or 
other narcotics may be used as the 
substitute. However, methadone has be 
come most widely accepted, and, be 
ginning with an initial dose of about 
40 mg. daily, can be safely and gradu 
ally reduced until no narcotics are 
being employed. Other drugs tran- 
quilizers and antidepressants may 
also be used in conjunction with the 
methadone, and continued as necessary 
after the latter has been discontinued. 4 

But what about the second and third 

40 THE CANADIAN NURSE 



recommendations of the Rolleston 
Committee? How are they to be in 
terpreted? With our present knowledge 
of the treatment of addicts, both of 
these recommendations are more sub 
ject to criticism than when they were 
originally advocated. However, it is still 
true that treatment is frequently a dis 
mal failure, in spite of our opportun 
ities, and the question of the role of 
narcotic drugs in the therapeutic regi 
men still remains. 

NAF experiment 

The Narcotic Addiction Foundation 
of British Columbia is a private agency 
engaged in the treatment of the addict 
patient at liberty in the community who 
seeks treatment voluntarily. In 1963 
the NAF decided to apply the Rolles 
ton recommendations in the treatment 
of certain selected, and usually older, 
patients whose history indicated re 
peated failure in therapy. It should be 
noted that drug therapy, though fre 
quently an essential part of the treat 
ment and rehabilitative program, is not 
the only, or indeed the main aspect. 

The rationale for the procedures 
used depends on the recognition of the 
addict as physically, psychologically, 
and socially sick. He is a disturbed 
and dependent person, who has gradu 
ally focused his life around those pro 
cesses by which he obtains the drug, 
and the gratification he receives from 
it. Further, in most addicts of this 
group the dependency and self-des 
tructive needs are so great that to begin 
their therapy without the use of narcot 
ics (if they are at liberty and not in 
control) would be unthinkable. In other 
words, their motivation is poor, and 
their ability to get along without drugs 
in a reasonable way is minimal. 

We hoped that by administering 
methadone for a longer period, while 
at the same time continuing investiga 
tion into the physical, social and psy 
chological problems of the individual, 
and using suitable therapies (medical, 
psychiatric, counseling, re-education, 
job-training, and job-finding, etc.), we 
would be able to help the individual 
to become less dependent on the nar 
cotic, to reduce or resolve his social 
and emotional conflicts, and gradually 
assume more responsibility for him 
self. In such a program, the drug 



comparable in some ways to the pro 
longed use of tranquilizers or antide 
pressants in treating mentally ill pa 
tients in the community would be 
an essential feature of therapy, and 
would assist many addicts to lead more 
useful and constructive lives. Our ex 
perience with this method at the NAF 
has tended to confirm the above hypo 
thesis, and many "hard-core" addicts 
have given up their criminal and anti 
social behavior under this regimen. 5 

More recently, Dole and Nyswander 8 
in New York have experimented with a 
variation of this approach, and while 
results are still tentative, they again in 
dicate that for some addicts such an 
approach is worthwhile, is less costly 
to the community, and at worst helps 
to prevent many addicts from contin 
uing and repeating their cycle of 
drugs, criminality, jail, and more drugs. 

Changing attitude 

Since the aforementioned British 
recommendations were proposed, our 
understanding and approach to the 
treatment of the addict has gradually 
moved toward acceptance of him as a 
sick person who needs treatment, what 
ever other forms of control might be 
desirable. This principle is operative 
even when imprisonment is assigned 
for criminal acts. Within this past year 
a new federal drug treatment center for 
convicted offenders has been opened at 
Matsqui, in the Fraser Valley, British 
Columbia. After screening, selected ad 
dict offenders are sent to this center 
for treatment and rehabilitative mea 
sures, which will extend into after-care 
support, with extensive use of parole. 
These measures are the result of a 
changing and more enlightened social 
attitude about the causes and manage 
ment of addiction - - an attitude es 
sential to more sophisticated social 
action. 

Although this approach to treat 
ment is helpful to some addicts, it is 
by no means helpful to all. Many 
drug-dependent individuals require ex 
ternal controls in a clinic or hospital 
setting for some time before they have 
reached the degree of maturity, under 
standing, and social progress, which 
will enable them to exercise control 
over themselves while at liberty in the 
community. In New York and Califor- 

MARCH 1967 




MARCH 1967 



nia, legislation has been enacted that 
permits "committal" of suitable addicts 
to such a treatment setting; similar 
legislation is desirable in Canada. 

Conclusion 

The reader is referred to the recom 
mendations of the Special Committee 
of the Canadian Medical Association, 7 
which spells out the components of 
good medical care in the treatment of 
the addict. These include the following 
advice: "It may, in certain circumstan 
ces, be good medical practice to pre 
scribe maintenance doses of narcotics 
for long periods to an addict at liberty, 
if other components of good medical 
care are also provided. If they are not, 
the doctor may be guilty of trafficking. 
Our advice to general practitioners is 
that they should, if possible, avoid 
prescribing narcotics for long periods 
for addicts under their care." 

References 

1. Great Britain. Interdepartmental Com 
mittee on Drug Addiction. Drug ad 
diction; the second report. London, Her 
Majesty s Stat. Office, 1965. 

2. Division of Narcotic Control. Ottawa, 
Department of National Health & Wel 
fare, 1965. 

3. Special Committee on the Traffic in Nar 
cotic Drugs in Canada. Proceedings, 2nd 
session, 22nd Parliament 3-4 Elizabeth 
II, 1953-1954. Ottawa, Queen s Printer, 
1955. 

4. Halliday, R. Treatment of the narcotic 
addict. B.C. Med. Journal, 6: 421, 1964. 

5. Halliday, R. Narcotic drug addicts as 
voluntary patients; the use of metha- 
done on short-term and long-term with 
drawal treatment programs. Report to 
Committee on Problems of Drug De 
pendence. National Academy of Sciences, 
Washington, D.C., 1966, p. 4599 (Un 
published) 

6. Dole V.P. and Nyswander, M. Medical 
treatment for diacetylmorphine (heroin) 
addiction; a clinical trial with methadone 
hydrochloride. /. Amer. Med. Assoc. 
193: 646, Aug. 23, 1965. 

7. Good medical practice in the care of the 
narcotic addict. A report prepared by a 
Special Committee appointed by the Exe 
cutive Committee of the Canadian Medi 
cal Association. Canad. Med. Assoc. 1. 
1040-1043, May 8, 1965. D 

THE CANADIAN NURSE 41 



Care of patients addicted 
to non-narcotic drugs 

Nursing a patient who is addicted to drugs is much more difficult than nursing 
one addicted to alcohol. The drug addict takes longer to withdraw, wants to hang 
onto his chemical beyond reason, is wretchedly uncomfortable, jittery, and 
anxious for days. He tries the patience and ingenuity of the staff to the utmost. 



On admission to hospital, the per 
son addicted to non-narcotic drugs may 
appear intoxicated; but there is a subtle 
difference between him and the person 
intoxicated with alcohol. The drug ad 
dict s difficulty in walking is usually 
more marked than his ability to speak 
or comprehend. An alcoholic who 
finds it hard to maintain balance, looks 
half asleep, has incoherent speech, and 
usually falls into bed and to sleep 
quite quickly. The drug addict, on the 
other hand, has difficulty maneuvering, 
but is much more aware of what is 
going on; although his speech may be 
somewhat slurred, he makes sense. 

Quite often the patient has a mixed 
addiction - - to both sedative drugs 
and alcohol which may be sus 
pected by his unusual behavior. Fre 
quently a patient who is admitted for 
treatment of an alcohol problem de 
monstrates an additional problem by 
begging for a certain kind of drug. 
Staff are always aware of the possi 
bility that a patient is in the process 
of changing his dependence from al 
cohol to sedatives. From the stand 
point of clinical management, depend 
ence on alcohol is the lesser of two 
evils. 

Alcoholics may switch drugs 

Many alcoholics begin to use bar 
biturates or tranquilizers when, for 
various reasons, they can no longer 
take alcohol without being in trouble. 
One patient who had changed his de 
pendence from alcohol to pills was 

42 THE CANADIAN NURSE 



Mary L. Epp 



brought to hospital by his wife. It was 
a frustrating conference. His wife was 
threatening to leave him, the doctor 
was stressing the dire physical and 
mental consequences of his continued 
use of pills, and his employer was sug 
gesting that he was in danger of losing 
his job. But he sat there quite happy 
through it all. He was so thoroughly 
tranquilized that he was incapable of 
worry and refused to stay for treat 
ment. He might have been more ame 
nable to reason the next morning after 
he had "slept off" some of his sedative. 
Other persons start taking drugs on 
prescription, but increase dosage until 
it is so out of control that they be 
come intoxicated, fall down frequent 
ly, and are quite unable to cope. 

Choice of drugs 

The drugs to which a person may 
become addicted include anything that 
can change the way he feels, such as 
Aspirin, A.P.C. & C s, barbiturates, 
tranquilizers, bromide, paraldehyde, 
amphetamines, chloral hydrate, codei 
ne, morphine, heroin, methadone, De- 
merol, or mixtures of these. When a 
person is becoming dependent on a 
drug he is very careful not to run out 
of his special brand - - although he 
may take only a few pills a day. Later 
in the addiction he will not be as par 
ticular about the type of drug he uses, 
as long as there is plenty. 

Mrs. Epp is Director of Nursing at The 
Bell Clinic in Willowdale. Ontario. 



Clothing and luggage searched 

A good way to admit a patient who 
is addicted to drugs is to take him 
directly to an examining room, where 
he is seen by the admitting doctor 
while his luggage is left elsewhere and 
very thoroughly and carefully search 
ed. His pyjamas and dressing gown 
are taken to him only after all pockets 
have been checked; his clothes are 
removed from the room and examined 
for drugs. Pills have been found in 
trouser cuffs and billfolds - - in fact, 
almost anywhere. A woman has many 
hiding places among her cosmetics. 

The examination of clothing and 
personal effects should be done rou 
tinely even though the patient seems 
to be sober, is charming and good 
looking, and assures you he has noth 
ing to hide. At the risk of feeling 
foolish for insisting on this routine, 
you must resist the temptation to escort 
the patient directly to his room. After 
you have been fooled a few times you 
will be quite matter-of-fact about the 
searching performance even if you 
have to do it in front of the patient. 

These patients are not trustworthy 
while they are undergoing withdrawal 
and we can help them only when they 
realize that they cannot manipulate the 
staff. Actually, most patients expect to 
be searched. 

Some patients arrive with an as 
tonishing variety of pills scattered 
among their belongings. Besides the 
tranquilizers and/or barbiturates, they 
often have laxatives, diuretics, antacids, 

MARCH 1967 






*r 




MARCH 1967 



pills for hypertension, etc. It is im 
portant to take every pill away. After 
consulting the family physician, the 
staff doctor will decide which ones, 
if any, the patient requires. 

Withdrawal routine 

During treatment, we are careful 
to avoid transferring a patient s de 
pendence to another type of pill. This 
is particularly true when treating pa 
tients with a drug that demonstrates 
cross-tolerance with the addicting drug. 
Patients are told that they will have 
to put up with some discomfort. If 
they are made as comfortable on the 
new pill as they were on the old, they 
will never recover. 

At the beginning of treatment a 
drug addict finds it difficult to coop 
erate. Do not expect him to tell the 
truth about his addiction. To plan the 
treatment of his withdrawal reaction 
it may be important to know how 
much he has been taking; however, 
you cannot rely on what he tells you. 
This may be partly because he is 
ashamed of his addiction and partly 
because he quite truthfully does not 
know. It is a well-known fact that 
many so-called suicides are the result 
of unintentional overdose. The addict 
forgets how much sedative he has 
taken or is too impatient to wait for 
the drug to take effect. 

Barbiturates 

If the patient has been taking large 
amounts of barbiturates for a long 

THE CANADIAN NURSE 43 



time, he may have a convulsion on 
abrupt withdrawal in spite of treatment 
with anticonvulsant drugs. Under these 
circumstances the physician usually 
withdraws the barbiturates gradually 
and administers both tranquilizers and 
anticonvulsants concurrently. If the 
patient is addicted to a tranquilizer, he 
is usually switched to another tran 
quilizer at once and the dosage is 
gradually reduced to zero. 

Paraldehyde 

Paraldehyde makes an alcoholic feel 
wonderful. It is a derivative of alcohol 
and much stronger. To many alcoholics 
who have learned to put up with the 
taste and smell, this is the drug of 
choice on withdrawal. The odor, of 
course, is unmistakable and the nurse 
can only hope that when a patient is 
admitted smelling of paraldehyde, it 
has been prescribed for him, and not 
taken voluntarily for its "welcome" 
effects. In the latter case there may 
be considerable difficulty withdrawing 
the patient from his drug. 

Amphetamine 

The withdrawal reaction of the am 
phetamine addict is in sharp contrast 
to that of the addict to sedative drugs 
or alcohol. He is very sleepy and dull 
and complains of having difficulty in 
thinking. If he is presumed to be an 
amphetamine addict and does not 
behave in this way, we may suspect 
a mixed addiction, that he has some 
concealed supplies, or that he plans a 
trip to the drug store at the first op 
portunity. 

Support from staff 

A great deal of time is spent by 
the staff in reassuring and getting ac 
quainted with patients in the first 
stages of a recovery program. Persons 
addicted to drugs need to learn to de 
pend on people rather than chemicals 
and they start with a new dependence 
on the hospital staff. When this shift 
in dependence begins, the staff must 
be prepared to accept it for a pro 
longed period, sometimes years, while 
hopefully the patient learns to depend 
on other people as well. 

44 THE CANADIAN NURSE 



Patients may choose a particular 
member of the staff as their "mentor." 
Care must be taken to maintain a 
professional, although friendly, atti 
tude. A rule that patients are seen only 
at the clinic or hospital and that phone 
calls all take place while the nurse is 
on duty is a stabilizing influence. No 
staff phone numbers are released to 
patients 

Sitting down and chatting with the 
patient will help to pass the time for 
him and also give you a better idea of 
just how the withdrawal is going. Pa 
tients may put on a show to get more 
pills or more attention. We must try 
to understand that they are probably 
afraid of life without their chemical 
comfort. Sometimes a patient can be 
helped to appreciate his situation by 
comparing his continuous drug intoxi 
cation to a big downy comforter which 
he has wrapped around himself as pro 
tection from all his problems. As he 
is withdrawn he becomes naked and 
vulnerable and is hurt over and over 
again. A scolding from his wife, loud 
noises, the idea that he may have 
damaged himself permanently, all hit 
him with nothing to cushion the blow. 

With growing awareness that the 
staff is capable and really wants to 
help him, the patient becomes less 
apprehensive about being withdrawn 
from his chemical comforts. During 
the withdrawal period he desperately 
needs attention and kindness, and often 
finds it hard to believe that the nurse 
cares what happens to him. Your con 
cern and belief that he can be better 
gradually penetrates and he begins to 
have some hope that life without pills 
is possible - - if not too acceptable 
at first. 

It is amazing how soon patients 
want to get up and around. Thev will 
set cleaned up as well as they can and 
Join the other patients no matter how 
thev mav feel or how shaky and un- 
steadv thev are. Sometimes the staff 
mav fear that these patients will fall 
or disturb other patients; but it would 
seem that the comfort they get from 
being with others, even though they 
may be dozing part of the time, as 
sists the withdrawal process. 



Visits after discharge encouraged 

Persons who have been discharged 
from hospital are encouraged to visit 
the staff regularly. Most ex-patients 
particularly enjoy a chat with their 
favorite nurse, but anyone is better 
than no one. Other members of the 
staff, therefore, must be prepared to 
help if someone s patient phones or 
visits when she is off duty. He may 
be unhappy and jittery and will need 
to be encouraged to put up with the 
way he feels for the time being. We 
hope that he will learn, too, that talk 
ing with any understanding person can 
be of help. This points up the neces 
sity for regular staff conferences, as 
well as the importance of recording the 
nurses conversations about patients. 

Not all recover 

Unfortunately, some persons are so 
emotionally disturbed and so chroni 
cally uncomfortable that they are 
unable to function in society at all 
without some chemical dulling of un 
pleasant reality. For such patients, 
the smallest dosage which will enable 
them to carry on is maintained. It 
may be necessary to change the kind 
of medication occasionally as their 
tolerance for one kind builds up. 

Conclusion 

It is important for nurses to realize 
that although it may take a great deal 
of effort and a long time, it is pos 
sible to help most people to learn to 
live without sedative drugs and to be 
come more comfortable through im 
proved communication with others. D 



MARCH 1967 



Deserter of people? 

"Few nurses have patients like mine, which include grand champion show dogs, 
lovable mongrels, cats, and even a few feathered friends." 



Jean Wilkinson 



I am employed as a nurse in the 
Small Animal Surgery at the Ontario 
Veterinary College in Guelph, Ontario. 
How did I get here? Almost acci 
dentally. 

In the fall of 1964, I heard by the 
grapevine that the services of a nurse 
were being considered for the operating 
room at O.V.C. Because of my interest 
in animals and the enticement of regu 
lar hours of work, I investigated. At 
the time, I had been on the staff of a 
Guelph hospital for 10 years since my 
graduation as a registered nurse in 
1949. I am married, have two teen 
age sons, and, of course, a dog and cat. 

Many patients referred 

In the Small Animal Department at 
the Veterinary College, there is a hos 
pital and outpatient clinic for the pub 
lic. All pets of local residents are 
received on appointment, examined by 
a clinician on staff, and given treatment 
or hospitalized as inpatients. 

Many difficult cases are referred to 
the clinic by out-of-town veterinarians. 
Animals are sent here from all over the 
country, from as far west as British 
Columbia, and as far east as the Mari 
time provinces. Many, too, are natives 
of the United States. 

A variety of patients 

Our patients include grand champi 
on show dogs, field trial dogs, and 
many good old lovable mongrels. Cats, 
too, are represented on our patient list. 

Occasionally our feathered friends 

MARCH 1967 




/ IM 

Mrs. Wilkinson is nurse in the Small 
Animal Surgery at the Ontario Veterinary 
College in Guelph, Ontario. 

require treatment. An old grey owl had 
a broken wing pinned successfully; a 
snow goose had a tumor removed; and 
a peacock and homing pidgeon re 
quired medical care. Birds are poor 
anesthetic risks, however, and rarely 
become surgical patients. 

Animals have many of the same 
diseases as man plus some peculiar to 
themselves. The following operations 
are done on dogs and cats: tonsillecto- 
my, splenectomy, cystotomy, lobecto- 
my, diaphragmatic hernia repair, tho- 



racotomy, kidney transplants, open- 
heart surgery, thoracic surgery, lami- 
nectomies, and all types of orthopedic 
surgery. Pins and plates are used al 
most daily in some unfortunate dog 
who has met an accident with a car. A 
fractured femur, radius, tibia, pelvis, 
etc., can be pinned or plated success 
fully and "Fido" will be up and run 
ning about on all four legs in a matter 
of a few weeks. 

Occasionally we have a cesarean 
section. It s quite exciting when several 
people are "puppy rubbing" the small 
pink-nosed puppies who squeak loudly 
at this indignity. After the mucous is 
removed from nose and mouth, the 
newborn is placed in a heated box with 
several brothers and sisters - - any 
number, from one to nine. 

Strict aseptic technique in O.R. 

The surgery here is modern, air-con 
ditioned, and well-equipped. We have 
three operating rooms plus a scrub 
room and working area. The operating 
suite could be compared to one in a 
small hospital. The most stringent asep 
tic technique in operating room pro 
cedure is carried out for all animals. 
Doctors scrub, gown, and glove. 

Before the animal is brought in, his 
operative area is shaved and the skin 
cleansed with antiseptic. Dogs and cats 
are anesthetized and wheeled in on 
stretchers. The most common anesthe 
tic for these animals is Nembutal, given 
intravenously. Sodium Pentothal and 
Surital are used intravenously for mi- 

THE CANADIAN NURSE 45 



The operating rooms for small animal 
surgery are modern, air-conditioned, 
and -well- equipped. 



Strict aseptic technique is carried out 
for all types of surgery. 





nor surgery and for anything that re 
quires a short-acting anesthetic. 

We have two large anesthetic ma 
chines for fluothane inhalation, used 
mainly on older dogs that are poor 
anesthetic risks, or for animals that 
require thoracic surgery. The animals 
are all intubated with endotracheal 
tubes for a clear airway during anes 
thesia, and then are draped with sterile 
drapes, the same as in operating room 
procedures for a human. 

A central service department cleans 
and sterilizes instruments, drapes, and 
equipment. Most of our surgery is done 
in the afternoon since this is a teaching 
university. The mornings are free for 
lectures and clinic office hours. 

Very few patients are lost during 
surgery. Intravenous stimulents, oxy 
gen, and respirators are available if 
needed. The use of intravenous saline 
dextrose and whole blood transfusions 
is common. 

Research 

The research work done in this de 
partment may be of help in human 
surgery some day. I have had a small 
part in helping with some work done 
on research of bone healing. This was 
carried out on rabbits as a postgraduate 
study. Another beneficial research pro 
gram is one that has been done on 
Legg-Perthes disease. This may prove 
beneficial to children. Hip prosthesis 
was pioneered on dogs a few years ago. 

Not a deserter of people 

I noticed that a reporter headlined 
me in a column last year as a "deserter 
of people." However, I still have a 
close relationship with people through 
their family pets. Pet owners are a very 
devoted lot. They like to see their pet, 
who is just like one of the family, get 
the very best care possible. If I am 
helping in some small way to do this, 
then I have not let "people" down. D 



46 THE CANADIAN NURSE 



MARCH 1967 



Standardization 



Many things we take for granted have been standardized for our convenience 
and safety. Would greater standardization in products and procedures 
help our patients? 



George T. Maloney 



Imagine if there were ten ways to 
tell time. Suppose half the people on 
highways drove on the left side as 
a matter of choice. What if there was 
a dispute as to whether to stop or go 
on a red light. 

It is obvious that many things that 
we take for granted in our lives have 
been standardized for convenience and 
safety. 

There is even considerable stan 
dardization within individual hospitals. 
However, there is little standardiza 
tion from hospital to hospital, and 
this creates problems. One special 
aspect of this is standardization of 
medical-surgical supplies and equip 
ment. As early as 1931 the United 
States government set up a committee 
to investigate this, but the battle to 
standardize has been a losing one. 
There are still as many techniques of 
doing a procedure as there are doctors 
and nurses in a hospital. 

One example from a manufacturer 
concerns needle sizes. "There are few 
doctors or nurses who would know any 
difference between a 20-gauge, IVi- 
inch needle and a 21 -gauge, l ] /4-inch 
needle if they did not read the label. 
Yet there are as many different sizes 
as there are users in some hospitals !" 

One hospital had been using 10 
different sizes of needles; a product 
manager convinced the staff to use 
just three standard sizes for a one- 
month trial. One month later they 
wondered why they had ever needed 
all the other sizes in the first place. 

Individual preference 

The individual doctor, by law, is 
MARCH 1967 




Mr. Maloney is Vice-President in charge 
of Merchandising for C.R. Bard, Inc., 
Murray Hill, New Jersey. This article is 
adapted from a speech presented to the 
Mid-West Hospital Association Annual 
Convention in Kansas City last fall. 

allowed to practice the art of healing 
according to his own discretion. More 
uniformity in teaching in medical 
schools would help to reduce the 
various whims of the individual doc 
tor. The same applies to nursing 
schools. 

Today, commercially prepared, pre 
packaged, preassembled, presterilized 
tray setups are coming on the market. 
A host of manufacturers are preparing 
them. These people recognize the im 
portance of the concept of a standard 



"for one and for all" if there is to be: 

more convenience 

better service 

smaller inventories 

assured quality 

If hospitals will not accept a stand 
ard setup they will get greater ag 
gravation. 

Nurses may already have experienc 
ed some of the problems associated 
with specially-prepared sets. "It s 
late!" "Something s missing!" "They ve 
used the wrong item!" Then it begins 
- phone calls, questions, answers, 
promises, explanations. 

How efficient would any central 
service be if it had to prepare 10 to 
20 variations of the same setup ? How 
much higher are costs when special 
parts must be purchased for the varia 
tions as opposed to the cost-saving 
of quantity purchase ? How much 
more storage space is required if sever 
al variables of an item must be stocked 
according to glove size, needle size, 
syringe size, and so on ? 

Compound these problems by 
1,452* hospitals in Canada and you 
have an idea of the number of poten 
tial problems facing manufacturers 
and dealers. 

High costs of specials 

Manufacturers, because of compe 
tition, have catered to these individual 
preferences and have made "specials." 
In other words, the salesman is told 
that if the tray is not prepared special 
ly for that hospital, it will be ob 
tained from another manufacturer. 

*Dominion Bureau of Statistics, List of 
Canadian Hospitals (83-201) 1965, p. 6. 

THE CANADIAN NURSE 47 



However, if this trend continues, 
prices will have to rise. 

An excellent analogy is what has 
happened in the automotive industry. 
From Henry Ford s "I ll paint it any 
color as long as it s black" concept, 
there is now a huge range of models. 
A spokesman for Ford stated that 
it is conceivable that they could go 
through an entire year without making 
two identical automobiles. It does not 
take much "gray matter" to under 
stand the reason for the high cost of 
an automobile. Many people believe 
that as volume goes up, price comes 
down. The converse of this is true in 
the automobile industry because most 
cars are "specials." 

Hospitals often fail to understand 
the reason for a higher price on a 
special. For example, if their special 
is created by removing a part, some 
believe that the price of the tray 
should be reduced proportionately. 
What has to be taken into considera 
tion is not only the cost of the part; 
when there is deviation from a stand 
ard product, closer supervision and 
more production training is necessary 
because more problems are created. 

With a standard product, prod 
uction follows a pattern and those 
involved develop a greater degree of 
skill. This naturally leads to greater 
ease in training employees, and 
greater proficiency of work. Also, all 
manufacturing costs, particularly low 
labor and inventory costs, mean less 
money tied up in production. The 
customer then receives a quality 
product at a lower price. 

Standardization will come 

Manufacturers, doctors, nurses, and 
hospitals are all in the business of 
providing safe, effective, quality 
patient care. Standardization will 
help, but all will have to coordinate 
efforts to achieve it. 

First, simple, honest communica 
tion is essential. At many a conven 
tion, someone has stopped by our 
booth and requested a "special." After 
he has been told about the time, 
trouble, and expense necessary, and 
that there was no guarantee that the 
product would satisfy, he invariably 
expressed thanks and understanding 
of the problem. 

Second, a natural evolution will 
occur, because neither the hospital 
nor the dealer will be able to eval 
uate all the new products introduced 
each year. Dealers will influence the 
tendency to standardization. They do 
not have the space for four variations 
of the same tray, nor the time to learn 
the selling features. The space pro 
blem need not be elaborated as every 
one is aware of the problems of keep- 

48 THE CANADIAN NURSE 



ing up with space demands caused 
by disposables. However, the cost 
and disadvantages of returning to 
reusables is obvious. As the fellow 
said: "Horse travel doesn t cost as 
much as going by jet, but who is going 
to travel by horse ?" 

To be profitable, disposable business 
must be done on a volume basis. Com 
petition will eventually force manu 
facturers to standardize or get out 
of certain areas. 

Third, the introduction of electro 
nic equipment and items such as the 
dataphone will help to bring stand 
ardization. Recently, eight hospitals 
in an area organized to share com 
puter facilities to improve patient ser 
vice and hospital administration. The 
new system will help control inven 
tories of more than 2,500 different 
stock items and will provide greater 
economies in supply purchase. These 
eight hospitals have had to come to 
agreement on basic items. 

Fourth, labor problems will also 
bring standardization more quickly. 
Hospital rates are rising rapidly as 
higher salaries are obtained by nurses 
and other hospital employees who 
have been underpaid in past years. 
Hospital administration will aim for 
increased efficiency and one way will 
be through increased standardization. 

A fifth factor affecting standard 
ization is that the practice of medi 
cine is changing. Dr. Oscar Creech, Jr., 
Professor of Surgery and Chairman of 
the Department at Tulane University 
School of Medicine, recently predicted 
that by 1990 medicine will be prac 
ticed on an assembly-line basis. He 
pointed out that neither patients nor 
physicians are ready for such changes, 
but radical changes in the practice of 
medicine are inevitable and the pro 
fession must prepare for them so as to 
dictate in some measure how they will 
occur. Standardization of equipment 
and supplies will play a part if this 
prediction becomes reality. 

In the United States, the Federal 
Government is becoming increasingly 
involved in the medical industry, and 
with Medicare it will become even 
more concerned with costs. It is to be 
hoped that the industry itself will un 
dertake cost control and not invite the 
government to take over. 

Manufacturer s goals 

Manufacturers must meet the crite 
ria of quality of the medical industry 
in all products. Each item must be of 
a quality that is adequate for its spe 
cific purpose. Therefore, the purpose 
must be spelled out before work can 
begin on a product. Again, communi 
cation between user and manufacturer 
is essential as trial and error evalua 



tion help to elucidate additional factors 
and more useful methods. 

Many techniques of communication 
may be used: 

1. Questionnaires are devised for 
each specific product. These are kept 
simple and concise, but include a com 
ment section. Some questionnaires are 
sent by an agency so that the manu 
facturer s name is not used; others are 
designed to be used by salesmen during 
a "market test" phase of a product. 

2. Consultants are sent to approxi 
mately 100 hospitals to check out var 
ious aspects of a product in the actual 
situation. Monthly reports are sent in 
on the product. 

3. Recently, an advisory panel has 
been used effectively. The panel for 
an item used in nursing would include: 
five nurses from the nursing adminis 
tration office (either the director or her 
associates); three operating room su 
pervisors; nine central supply super 
visors; one nurse from the intravenous 
team; one nurse with special interest in 
research and development; and one 
purchasing agent. 

The panel meets for a day to pre 
sent concepts and prototypes and to 
evaluate existing products. The atmos 
phere is relaxed and informal and cri 
ticism is encouraged. 

4. Organization within the industry 
can also help. A new group of market- 
in" people from 31 companies held a 
meeting at which competitors sat to 
gether and agreed that they could, and 
should, work together toward certain 
aspects of standardization. 

Identical goals 

Standardization will benefit patient 
care, but it needs cooperation and 
communication and time. 

In a recent editorial in the Journal of 
the American Hospital Association ma 
gazine, Hospitals, it was stated: "A 
need exists for more standardization, 
simplification, higher standards, bet 
ter communication, more efficient 
marketing techniques, and more co 
operative efforts by hospitals and in 
dustry to develop products for hospital 
use... Better communication between 
hospitals and supply firms is also 
needed about product research and 
development and also use of equip 
ment and supplies in patient care- 
Hospitals should not only be willing 
to assist industry by discussing in use, 
patient-care factors that may affect 
proper design, but also should realize 
that this is a continuing responsibility 
of the hospital field. Industry, on its 
part will find that involving profes 
sional and hospital personnel early in 
the development stages of hospital 
equipment will be advantageous..." 

This sums it up quite solidly. 

MARCH 1967 



Hospital and health care 
what price? 



Often we are informed that the local hospital s costs have increased 20 percent 
in the past year. This raises the question of how much each individual 
is going to have to supply to cover the increase. 



S. ). Maubach, B. Comm., C.A. 



Almost daily, news media make 
Canadians aware of skyrocketing hos 
pital costs. While all this informa 
tion is of great interest to the indi 
vidual, it unfortunately fails to reveal 
how much of the total cost is diverted 
from one s personal income. If one 
considers all the various types of taxes 
to which one s income is subjected, 
it becomes clear that it would be an 
exercise in futility to attempt to com 
pute any given individual s share of 
hospital costs. 

Hospital operating costs 

Public general hospitals, with few 
exceptions, come under provincial 
jurisdiction. It is left to provincial 
governments to negotiate with hos 
pitals, individually, to determine the 
amounts that each hospital is entitled 
to receive in order to offer hospital 
care to those requiring it. 

However, in the Canadian system 
of taxation the federal government 
collects a part of the taxes earmarked 
to pay hospital costs, which in turn 
are transferred to the provincial gov 
ernments. As the amounts received 
from the federal government cover 
approximately half (depending on the 
province involved) of shareable hos 
pital costs, it remains to the province 
to raise most of the remaining balance. 
This is accomplished through various 
tax-raising programs and, in some 
provinces, through direct contribu 
tions from individuals. 

In some provinces, authorities may 

MARCH 1967 



raise funds to reimburse hospitals for 
their costs through a combination of 
the foregoing methods. For instance, 
in Ontario a married man must pay, 
or have paid on his behalf, $6.50 
per month to the provincial plan for 
prepaid hospital care. However, the 
total collected by the province in this 
manner is insufficient to provide 
enough funds to reimburse hospitals 
for the province s share of costs and 
it therefore becomes necessary to al 
locate monies gathered from some 
other source to the hospital cost pool. 
In Quebec, individuals do not make 
direct payments to the provincial 
government in the form of premiums; 
the provincial government s share of 
hospital costs is financed through 
general tax programs. In British 
Columbia, yet another innovation is 
found. Each hospital patient must 
pay one dollar per day to the hos 
pital while he remains in the institu 
tion, in addition to the amount he 
pays to the government. 

Here then we see the individual 
may pay for hospitalization to three 
parties: the federal government, the 
provincial government, and the hos 
pital in which he becomes a patient. 
These are but a few examples to il 
lustrate how complicated it would be 
for any individual to determine how 
much one actually does pay toward 
hospital costs. 

Mr. Maubach is Lecturer, School of Hos 
pital Administration, University of Ottawa. 



Furthermore, it must be noted that 
most provinces do not reimburse each 
hospital its total costs incurred in 
the treatment of patients. For in 
stance, in all provinces except Mani 
toba, depreciation on hospital buil 
dings must be absorbed by the hos 
pital. Interest on capital debt is not 
generally covered in reimbursement 
formulas except in Alberta and Mani 
toba. 

Hospital capital costs 

Up to now mention has only been 
made of the funds required in the day- 
to-day operations of the hospital. 
Where does the money come from to 
build the hospital in the first place ? 
As with operating costs, both federal 
and provincial governments are invol 
ved in financing part of the capital 
required to construct and partially 
equip hospital facilities. 

These two levels of government 
combine to underwrite, in most cases, 
a large portion of the total cost; the 
amount varies from province to pro 
vince. However, the federal program 
is constant for each project. It is there 
fore left to most hospitals to find other 
sources of funds to finance that por 
tion of capital costs not provided for 
by federal and provincial authorities. 
These funds are derived from several 
possible bodies municipal govern 
ments, philanthropic organizations, 
religious orders operating the hos 
pitals, and, needless to say, you and I. 

THE CANADIAN NURSE 49 



Federal 
Government 



Taxes 



Tax-Shared Programs 



Taxes and Premiums/ 



Provincial 
Government 



lApproved Costs 



Individual 


/ Charges 
Not Paid by Plan 


j 


A Public General 
Hospital 


Donations 





Property Taxes 



Municipal 
Government 



Possible 
Financial 
Support 



Religious 
Bodies 



CHART 1 



Philanthropic 
Bodies 




Source and allocation of 
hospital funds 

It might be well to follow the flow 
of funds to their final destination 
the hospital. Taxes collected by the 
federal government are passed on to 
the provincial governments under an 
established formula. This money goes 
into a provincial hospital pool. The 
provincial government raises money 
from taxes or premiums, or both, and 
these are also allocated to the hospital 
pool. This pool of funds is then distri 
buted to individual hospitals based 
on a negotiated budget, or other 
similar planning and control devices, 
which is meant to repay the hospital 
for approved costs incurred in treat 
ing patients in a standard ward. 
Should the patient prefer accommoda 
tion superior to that of the standard 
ward, it is necessary that the indivi 
dual pay an extra fee to the hospital. 
These extra funds obtained by the 
hospital are sometimes shared with 
the province and the portion retained 
by the hospital is meant, in part, to 
cover losses suffered by the institu 
tion. (Chart. 1.) 

Not to be forgotten are those hos 
pitals which serve the outpatients of 
50 THE CANADIAN NURSE 



the community. In varying degrees, 
most of the provincial plans do not 
reimburse the hospital for the entire 
costs, sometimes substantial, incurred 
in rendering this service. 



Table 1 

Projected 1966 Expenditure on 

Personal Health 
Services and Facilities 1 



Service 

Physicians 

Dentists 

Other Health Services 

Health Insurance Admin. 

Prescribed drugs 

Hospital Services 

TOTAL SERVICES 
HEALTH FACILITIES 

TOTAL 



Cost 
Per Capita 



$ 



24.91 
8.00 
7.14 
4.68 
7.56 

73.89 



$126.18 
8.27 

$134.45 



1. Royal Commission on Health Services, 
Volume 1. Queen s Printer, 1964, p. 843. 

2. Ibid., p. 851. 



Other health facilities 

While this article has so far been 
restricted to the hospital field, some 
reference should be made to other 
health care costs in order that some 
idea may be given of the magnitude 
of the total health care picture which, 
directly or indirectly, must be paid 
for by the tax-paying public. 

The anticipated cost of health care 
in Canada in 1966 shows that $134.45 
would be spent for every man, woman 
and child. While the major portion 
goes to hospital services, $60.56 per 
man, woman and child will go to other 
services and health facilities. (Ta 
ble 1.) 

While the figures in the table give 
a rough indication of total health 
care costs, it should be pointed out 
that they are shown on a per capita 
basis. If you happen to earn higher 
than average income, your share of 
the cost is substantially higher. 

Even though it now appears impos 
sible to determine how much we, as 
individuals, pay toward hospital and 
other health care costs, we undoubted 
ly receive much better care than our 
forefathers did. However, in view of 
the rapidly changing nature of health 
services offered to us, the day will soon 
arrive when the politicians, health 
care leaders and the Canadian public 
must determine how much income is 
being spent and should be spent for 
our well-being. H 

MARCH 1967 



research abstracts 



The following are abstracts of studies 
selected from the Canadian Nurses As 
sociation Repository Collection of Nursing 
Studies. Abstract manuscripts are prepared 
by the authors. 

Buchan, Irene M. A Study of inactive 
nurses in Alberta, Canada, to determine 
selected characteristics, reasons for in 
activity, and the extent to which they 
represent a potential nursing resource. 
Seattle, 1966. Thesis (M.N.) University 
of Washington. 

The study was done to determine: 1. the 
characteristics of inactive nurses; 2. the 
reasons for their inactive status; and 3. the 
extent to which inactive nurses planned to 
return to full-time or part-time nursing 
employment. 

Data were gathered by a questionnaire. 
The respondents comprised 374 inactive 
nurses in Alberta. Data from the question 
naires were tabulated according to four 
categories: 1. nurses who had already re 
turned to active nursing; 2. inactive nurses 
who planned to return to active nursing; 
3. inactive nurses who were uncertain about 
returning to active nursing; and 4. inactive 
nurses who did not plan to return to nur 
sing. In order to present a composite 
picture of the inactive nurse, data from 
the questionnaires of the latter three 
categories were tabulated and analyzed. 
Questionnaires of 43 nurses who were al 
ready re-employed were deleted from the 
study, leaving a total of 331 inactive nurses 
as the study population. 

The findings indicated that the respon 
dents represented a considerable potential 
nursing resource. A composite picture of 
the inactive nurse was presented. The three 
main reasons for inactivity given by the 
majority of the non-practicing nurses were 
concerned with home and family respon 
sibilities, arrangements for care of children, 
and personnel policies. Recommendations 
for further study were made. 

Neylan, Margaret S. The development of 
an evaluation Q-Sort; a study of nursing 
instructors. Vancouver, 1966. Thesis 
(M.A.) University of British Columbia. 

The purpose of this study was to develop 
an Evaluation Q-Sort and to test it by 
measuring the perceptions held by nursing 
instructors on the relative importance of 
five functions and effects of evaluation. 
The functions and effects identified for 
study were: the measurement of student 
achievement; the measurement of student 

MARCH 1967 



progress; psychological effects of evalua 
tion; the influence of evaluation on teach 
ing; and the influence of evaluation on 
administration. An Evaluation Q-Sort was 
developed and used to measure the percep 
tions of evaluation held by the 1 1 1 nursing 
instructors in the 6 professional nursing 
schools in the Lower Mainland and Van 
couver Island areas of the Province of 
British Columbia. 

The population was divided into 10 clas 
sifications according to various criteria 
related to role, experience, preparation, and 
instructional setting. The central hypothesis 
assumed that the group of instructors as a 
whole would not assign greater importance 
to any one of the 5 functions and effects 
of evaluation. The 9 sub-hypotheses assum 
ed that the perceptions of evaluation held 
by nursing instructors would not be in 
fluenced by the variables selected for study. 
The .05 level of significance was used in 
the study. 

The results indicated that the nursing 
instructors did ascribe significantly dif 
ferent degrees of importance to the 5 func 
tions and effects of evaluation. Measure 
ment of student achievement was ascribed 
least importance and measurement of stu 
dent progress was ascribed most importance 
among the functions and effects studied. In 
addition, differences were found with res 
pect to the nature of the instructors res 
ponsibilities, the type of school in which 
she taught, and her stated level of satisfac 
tion with preparation as an evaluator. No 
differences were found with respect to 
length of experience in nursing service or 
education, preparation as an instructor, 
course in tests and measurements, instruc 
tional focus, and instructional setting. 



Arpin, Kathleen. A study to identify dif 
ferences, on selected factors, between 
university-qualified students who are 
enrolled in the first year of a bac 
calaureate or a diploma program in 
nursing. Boston, 1965. Field Study, 
(M.S.) Boston University. 

The study was undertaken to identify 
the differences, on selected factors, be 
tween university-qualified students who were 
enrolled in the first year of a baccalaureate 
program or a diploma program in nursing. 

The subjects selected for study were 
students enrolled in the first year of two 
baccalaureate programs in nursing and uni 
versity-qualified students in one diploma 
school of nursing. The schools taking part 
were located in large metropolitan cities 



in approximately the same geographical 
area. 

Data were collected by means of a mail 
ed questionnaire, administered by faculty 
members, which was developed to obtain 
information on the student s social class, 
social background, educational background, 
reasons for selection of school, interest 
in further education, and other related 
factors that might influence a student s 
selection of a particular type of school. 
The responses to the questions were com 
pared and the differences and similarities 
described. 

The findings indicated that there were 
differences and similarities between the 
two groups. The major areas of difference 
were in social class, reasons for selection 
of school, interest in further education, 
and in social background on the items relat 
ed to parental attitude toward university 
education. There was little or no difference 
between the two groups on the remaining 
items used to gain information on social 
background, educational background, and 
on the other related factors that might have 
influenced a student s selection of a parti 
cular type of program. 

Recommendations include: 1. that a 
more definitive study of all students in 
grade 13, who have been accepted in either 
a baccalaureate or a diploma program, be 
done to determine the differences between 
the two groups, and 2. that a study of 
parents of grade 13 students who have been 
accepted in either a baccalaureate or a 
diploma program be done to determine 
their attitude toward university education 
for their daughters as compared to the 
students. 

Lennie, Clara May. A study of student 
achievement in an Alberta hospital school 
of nursing in relation to selected char 
acteristics of the mother. Seattle, 1965. 
Thesis (M.N.) Univ. of Washington. 

The purpose of this study was to explore 
the relationship between achievement of 
the student nurse in a diploma program 
and selected characteristics of the mother. 

A questionnaire, given to 236 second 
and third-year students, provided informa 
tion about the mother s characteristics and 
other biographical data. School records 
were reviewed for student achievement. 

The data revealed little relationship 

between the achievement of the student 

nurse and characteristics of the mother as 

measured by her preparation as a nurse or 

(Continued on page 52) 

THE CANADIAN NURSE 51 



research abstracts 



(Continued from page 51) 

in a related health field, level of education, 
present and past occupation, income, and 
by the mother-daughter relationship. There 
was some indication that the younger, 
single student who entered nursing directly 
from the parental home in which both 
parents were living together, received higher 
grades in nursing fundamentals, micro 
biology, and pharmacology II. The older 
student obtained higher grades in introduc 
tion to disease, and medical-surgical nur 
sing. When mothers were employed before 
marriage, daughters did better in social 
sciences. Students from larger families, 
daughters of mothers employed part-time, 
daughters of mothers currently employed 
in a hospital, and daughters who thought 
parents should guide them in career choice, 
received higher grades in several measures 
of achievement. 

Baribeau, Pierrette. A study of expressed 
dttinides of Lamaze fathers toward labor 
and delivery experience. Boston, 1964. 
Thesis (M.Sc.) Boston University. 

This exploratory study is concerned with 
the father s attitude toward the labor and 
delivery phase of his wife s pregnancy. 
The investigation was conducted within the 
realm of the Lamaze method of childbirth. 
It was assumed that by defining the father s 
role during this important event, the Lamaze 
method was contributing to the reduction 
of the father s anxiety by an increased feel 
ing of participation. 

The sample included six fathers whose 
wives had had a succesful labor according 
to the Lamaze method. The fathers were 
present only during the labor period. Four 
of the fathers were doctors, one was an 
architect and the sixth was an assistant 
researcher. Three were having their second 
or third experience with the Lamaze 
method of childbirth; for three, it was 
their first experience. 

The method of data collection was a 
partially structured interview with open-end 
ed questions. The interviews were conduct 
ed in offices, restaurants or in waiting- 
rooms. The responses were recorded verb 
atim with the aid of a tape recorder. 

The data were analyzed in relation to 
the father s attitude toward childbirth, 
labor, role perception, and the influence 
of his participation on these attitudes. 

In conclusion, it appears that the Lamaze 
fathers, as they gained more experience 
with the method, also gained more confi 
dence in the value of their participation. 
They expressed less anxiety verbally and 
in their reported behavior as long as they 
were allowed to be with their wives to assist 
them. They agreed that the Lamaze method 

52 THE CANADIAN NURSE 



is a support to the father because of the 
knowledge given, the defined task, and 
the rationale for active participation of 
the husband in the childbirth process. Some 
fathers expressed the belief that having 
something to do was a help to them. Their 
encounter with the Lamaze method left 
them with a feeling of satisfaction and a 
positive attitude toward childbirth. 

Consequently, it is recommended that 
prenatal classes should stress the import 
ance of usefulness of the father in the 
antepartal and partal period. Such classes 
should include, beside the usual knowledge, 
a better delineation of the father s role. 
Nurses should be aware of the father s 
need for a role definition and be prepared 
to supply such information. Furthermore, 
a study should be made to ascertain the 
degree of decreased anxiety experienced 
by the Lamaze fathers as compared to 
the amount of anxiety of other prepared 
fathers. 

McKinnon, M. Barbara, Sister. Coordination 
within the educational program in hos 
pital schools of nursing. London, 1965. 
Thesis (M.Sc.N.) Univ. of Western 
Ontario. 

This study was designed primarily to 
determine the need for greater coordination 
within the educational program as perceiv 
ed by directors, teachers, and head nurses 
participating in selected hospital schools 
of nursing programs. The project investi 
gates four main aspects of coordination, 
namely: 1. the perceived need for coordina 
tion, the degree of this need, and the 
reasons underlying it; 2. the functions that 
may conceivably be included in coordina 
tion; 3. an assessment of how well coor 
dination is currently carried out; the re 
cognized need for modification of activities, 



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and how this modification may be effected; 
4. the persons deemed most suitable to 
effect coordination, and their desirable 
qualifications. 

Since only 5 of the 63 diploma schools 
in Ontario employ an educational coordin 
ator, it seemed pertinent to explore the 
reactions of these coordinators regarding 
their recent appointments and the extent 
of their contribution to the school program. 

Findings from the study indicate the 
expressed need for greater coordination 
within the educational program in hospital 
schools of nursing. Evidence points to the 
advisability of charging one person within 
a school faculty with the primary responsi 
bility for coordinating the educational pro 
gram. The research data from this project 
should be assessed within the framework 
of further definitive study of the whole 
organizational pattern and allocation of the 
many functions involved in implementation 
of the educational program. 

Bell, Frances E. A study of programs in 
selected schools of nursing to determine 
the liberal education content of the 
curriculum with specific reference to 
learning experiences related to nursing 
of the aged. London, 1966. Thesis 
(M.Sc.N.) Univ. of Western Ontario. 

This survey study explores the liberal 
education content of the curriculum of 
four purposely selected schools of nursing, 
with specific reference to learning ex 
periences related to nursing of the aged. 
None of the schools in the sample are 
associated in the traditional manner with a 
hospital; two are located within multidisci- 
pline institutions, and two in single dis 
cipline institutions. 

Through the use of a questionnaire, data 
were collected pertinent to the following: 
the general education prerequisite for 
entrance; what comprises the general educ 
ation component; the means used to liber 
alize the professional education component; 
and how these are utilized with specific 
reference to learning experiences related 
to nursing of the aged. This study is not 
intentionally either comparative or evalu 
ative in relation to these curricula. 

Recommendations arising from the find 
ings in the study include: 1. repetition of 
the project using a larger sample with the 
possible development of tools for purposely 
comparing and evaluating the curricula 
studied; 2. research into what comprises 
the most appropriate general education 
background for entrance into basic schools 
of nursing; 3. further exploration through 
research and the continuing refinement of 
the curricula in schools of nursing to ascer 
tain how these may be optimally liberalized; 
4. strengthening of the general education 
and professional education preparation of 
teachers in schools of nursing to maximize 
their contribution to the liberalizing of the 
curriculum. 

MARCH 1967 



books 



Nursing Care of the Adolescent by S.L. 
Hammar, M.D. and Jo Ann Eddy, B.S., 
R.N. 232 pages. New York, Springer 
Publishing Company, Inc., 1966. 
Reviewed by Mrs. S. Lyons, nursing 
service supervisor, The Montreal Chil 
dren s Hospital, Montreal, Quebec. 

This text is informative, realistic frank, 
and practical. By discussing the normal 
phases of adolescence, and by explaining and 
interpreting the confusing physical and 
emotional changes that occur, the authors 
answer many questions and clear up com 
mon misconceptions. 

Dr. Hammar and Miss Eddy bring forth 
an important concept when they deal with 
the feelings of the nurse as well as those 
of the adolescent. They point out the need 
for the nurse to understand her own feelings 
before she can effectively cope with those 
of the adolescent and thus establish good 
rapport. 

The emotional responses and the be 
havioral changes of the "normal" adoles 
cent are discussed, and ways of helping 
him handle them are presented. In ad 
dition to stating a principle to be followed, 
examples of the "how" are included, which 
make the management more concrete and 
meaningful. This is followed by a discus 
sion of illness and the additional stress that 
this places on the teenager due to his hyper- 
sensitivity and uncertain self-image. 

Most nursing texts deal primarily with 
diseases and nursing care; however, this 
book emphasizes normal teenage growth, 
development, and behavior. The many 
unique problems confronting the sick ado 
lescent, either physically or emotionally, 
are discussed within this context. Each 
chapter of this paperback is followed by a 
summary and suggested reference readings. 

This book would help those dealing with 
adolescents in sickness or in health, at home, 
at school, or in hospital. It simply and 
directly discusses the many and unique 
problems confronting the adolescent, and 
explains the inconsistent behavior character 
istic of this age group, for example, resolu 
tion of the conflict between dependency and 
independency. 

The authors stated objective is met. "This 
book is not intended to be a comprehensive 
discourse on adolescence, for it neither 
covers the entire field of adolescence, nor 
details all illness found in this age group, 
but we hope that it will be a useful hand 
book." 

MARCH 1967 



Continuity of Patient Care: The Role of 
Nursing edited by K. Mary Straub, R.N., 
Ed.D. and Kitty S. Parker, R.N., M.S.N. 
232 pages. Washington, The Catholic 
University of America Press, 1966. 
Reviewed by the late Dr. {Catherine Mac- 
Laggan, director, School of Nursing, 
University of New Brunswick, Fredericton, 
N.B. 

The editors have done a yeoman job in 
their attempt to present a report of the 
1965 Workshop of the School of Nursing 
of the Catholic University of America. This 
workshop was "designed to consider the 
responsibilities of nurse practitioners in as 
suring continuity of patient care." 

The report is presented in two parts: 
presentation of main topics, and summaries 
of seminar proceedings. The first part is 
composed of the papers presented by com 
petent authorities, followed in some cases 
by discussions of these papers. The second 
part summarizes the discussion and the 
deliberation of the group sessions. Every 
one familiar with the workshop technique 



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will accept that repetition is unavoidable, 
and, of course, repetition is evident in this 
report. 

Details, such as demographic data, and 
legislation affecting maternal and child 
health services and mental health services, 
are American in orientation, but the inter 
pretation of these details is applicable to 
the Canadian situation. 

All nurses, to say nothing of the power 
figures in Canada who make the big deci 
sions about health, such as doctors, ministers 
of health, government officials, and admi 
nistrators of health services, should read 
the report to broaden their horizons on 
the meaning of continuity of patient care. 
For instance, Dr. Eleanor P. Hunt, a 
consultant on biostatistics to the research 
division of the Children s Bureau in Wash 
ington, says: 

"The health professions then have 
changed from their traditional role of im 
provement of the physical ills of an indi 
vidual on a personal basis to community 
based action leading to the prevention of 
disease and the correction of all physical, 
economic, emotional, and spiritual problems 
surrounding illness." 

While this has been said before in many 
contexts and in other words, it still counts 
as big news for those who make decisions 
and ensure action. 

To nurse educators, the report has im 
plications for curriculum development. To 
nurse administrators, it indicates the ex 
tent to which the base of operation in nurs 
ing services must be widened. To nurse 
practitioners, it provides some insight into 
the magnitude of the nursing role in con 
temporary society. 



Gynecologic Nursing by John I. Brewer, 
M.D., Ph.D., Doris M. Molbo, R.N., 
Ph.B., and Albert B. Gerbie, M.D. 171 
pages. St. Louis, Mosby, 1966. 

The subtitle calls this "A textbook con 
cerning nursing through an understanding 
of the patients themselves and their gyne 
cologic problems." It is directed toward 
aiding the student to develop good judg 
ment in patient care, rather than toward 
providing her with vast stores of facts. The 
book outlines some guides in human rela 
tionships as well as the necessary facts and 
procedures of gynecologic nursing. 

Because the authors have prepared a 
book that will assist nurses to make judg 
ments, much of the content involves con- 

THE CANADIAN NURSE 53 



books 



cepts that could be applied to all patients 
in hospital. Chapters on "The Essence of 
Nursing," "The Preoperative Patient," and 
"The Postoperative Patient," contain much 
material that is applicable to all surgical 
nursing, yet the approach is such that it 
is in no way repetitive. 

When the size of the book is considered, 
for it is a slim volume, one is impressed 
by the thoroughness and completeness of 
the material and the clear, concise method 
of presentation. It is an easy book to read. 
At the end of each chapter, lists of re 
commended reading for students, patients 
and instructors are given. 

The second chapter of the book, "The 
Patient s Symptoms," presents the three 
main gynecological symptoms: bleeding, 
pruritis, and pain. This discussion of symp 
toms, and their meaning to both patients 
and nurses, provides one of the best intro 
ductions to patient understanding to be 
found in a nursing text. A thorough expla 
nation of the psychological basis of symp 
toms is supplied. The section on pain is 
excellent and should be read by every 
nurse. 

Gynecologic Nursing deserves consider 
ation as a text in schools of nursing, and 
as well should be available on every ward 
that has gynecologic patients. It might 
also be required reading prior to inservice 
discussions for graduate nurses 

Maternity Care in the World, Interna 
tional Survey of Midwifery Practice 
and Training. Report of a Joint Study 
Group of the International Federation of 
Gynaecology and Obstetrics and the In 
ternational Confederation of Midwives. 
527 pages. 1966. Toronto, Pergamon 
Press. 

Reviewed by Miss Frances Howard, nurs 
ing consultant, Canadian Nurses Associa 
tion, Ottawa, Ontario. 

Another first has been added to the in 
creasing body of information on world 
health services. Through the joint effort of 
the International Federation of Gynaecology 
and Obstetrics and the International Council 
of Midwives, a world survey of maternity 
health services was begun in 1961. Maternity 
Care in the World is a compilation of the 
data obtained through this survey. 

The purpose of the study was to inves 
tigate the training and practice of midwives 
throughout the world. However the study 
group recognized the need to obtain other 
kinds of information related to the practice 
of midwifery. Vital statistics on maternal 
health services as well as information on 
the training and practice of midwives was 
obtained. 

One hundred and seventy-four countries 

54 THE CANADIAN NURSE 



CNA s Repository Collection of Nursing Studies 

Next month, Canadian Library Week will be observed. Last year THE CANADIAN 
NURSE recognized a sister association s special week by a feature article on the CNA 
Library. This year it seemed appropriate to describe a rather unique aspect of the library 
service, the CNA Repository Collection of Nursing Studies. 

Four years ago the decision was made that the Canadian Nurses Association 
would establish and maintain a collection of nursing studies. When the CNA library 
was established on a formal basis in 1964, this collection became the responsibility of 
the library. 

The collection now contains some 90 studies, and includes master s and doctoral 
theses and studies by government organizations and institutions. Their scope varies 
from major surveys of large areas or topics to investigations of relatively small scope. 
The only governing criterion is that the study is on a subject of concern to nursing in 
Canada, or, in the case of a thesis, was conducted by a Canadian nurse. 

The earliest study in the collection at present is the famous Weir Report, Survey 
of Nursing Education in Canada, printed in 1932 by the University of Toronto Press. 
This report is now out of print but is still very much in demand for schools of nursing 
libraries. This demand may now be met, in part at least, by loans from the CNA 
library. 

Recent additions to the collection include Portrait of Nursing; a Plan for the 
Education of Nurses in New Brunswick by CNA President, Dr. K.E. MacLaggan; The 
Study of Nursing Education in Canada by Dr. H.K. Mussallem for the Royal Commis 
sion on Health Services; The Report of the Ad Hoc Committee on Nursing Education 
in Saskatchewan (Tucker Report); master s theses from some of the 1966 graduating 
class at the University of Western Ontario; and A Study of Inactive Nurses in Alberta 
by Irene M. Buchan, a Canadian Nurses Foundation scholar, submitted toward a 
master s degree at the University of Washington. 

Canadian Nurses Foundation scholars are required, and other master s and doctoral 
students are encouraged, to deposit their theses in the collection. Since only minimal 
funds are available to assist the students to defray typing costs of a copy of their study 
for the collection, many students prefer to lend us a copy with written permission to 
Xerox it. 

Studies deposited in the collection are shown as received in the special listings 
in the CNA Bulletin and in the accession list of the CNA library in THE CANADIAN 
NURSE. 

In 1964, the Canadian Nurses Association issued an Index of Canadian Nursing 
Studies (now out of print). This issue of the Index included many studies for which 
copies were not available in the collection. In the revised Index the majority of the 
studies are available for consultation from the CNA collection of Nursing Studies. 

Now, still another key to the collection will be available in the form of selected 
abstracts that are to be published periodically in THE CANADIAN NURSE. 

Use of the collection as a resource tool for nursing research and studies increases 
daily, both at national office and across Canada by inter-library loan. Some studies 
are booked months ahead. The CNA Repository Collection of Nursing Studies, while 
still young and developing, is already proving of value to the profession and to the 
contributors. 



were included in the study. Data are re 
ported by country and by region. A com 
mentary is included for each country. Com 
parative tables illustrating data on maternity 
care and midwifery training and practice 
by country and by region are included. Vital 
statistical data are reported for the years 
1951 and 1961. In addition there is a 
summary of the world situation. Included 
are vital statistics, by region, and a sum 
mary commentary on methods of training 
and roles and functions of midwives. Prob 
lems of definition and registration which in 
hibit the conduct of global studies are 
noted. 

The study group recognized that recom 
mendations could not be made toward spe 
cific action in individual countries. Instead, 
recommendations relate to the conduct of 
similar national studies as a prelude to the 
establishment of national policies. Similar 



international studies are recommended for 
the future. 

It is also recommended that all countries 
aim at establishing uniform definitions, thus 
allowing for more conclusive comparative 
data. Other recommendations refer to re 
gistration of midwives, aid to developing 
countries, improvement of standards of 
training and practice, and increased country 
membership in the ICM and the F.I.G.O. 

Maternity Care in the World is described, 
in the preface, as "the end of the beginning." 
As such it is a valuable reference book for 
all health personnel involved with maternity 
services. It provides an opportunity to com 
pare progress with that of other countries 
and to learn of other methods of training 
and utilization of midwives. The recom 
mendations call for continued study and im 
provement and provide a directive for future 
action, internationally and nationally. 

MARCH 1967 




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books 



Migraine by Harold Maxwell, M.D. 64 
pages. Toronto, The Macmillan Company 
of Canada Limited, 1966. 
Reviewed by Miss W. Bell, director of 
nursing service, The General and Marine 
Hospital, Owen Sound, Ont. 

While Migraine has been written essen 
tially for the medical profession by one 
of its own members, this in no way detracts 
from its interest for those outside the 
profession, and particularly those afflicted 
by headache. Since we are told in the fore- 
ward that approximately one in ten of our 
adult population is affected, in some degree, 
by migraine, it should follow that this 
publication will be widely and thoughtfully 
read. 

Many theories are expressed as to the 
cause of migraine and it has been variously 
described throughout the centuries. Insuf 
ficient evidence gave no real support to 
the thinking of those who sought to clas 
sify it as an allergy. However, some evidence 
did indicate that migraine sufferers are 
more likely to be people who present 
neurotic symptoms, the most notable one 
being anxiety. It is thought that they pos 
sess unresolved, unconscious conflicts mak 
ing stressful life situations too difficult to 
handle. Somatic, hysterical and phobic feat 
ures may also be observed. However, it 
must be realized that there is no conclusive 
proof that migraine is the only affliction 
to which the foregoing symptoms are 
linked. 

The doctor-patient relationship is stres 
sed in a very positive way, and the rap 
port and relationship between the patient 
and general practitioner is highly signifi 
cant, being a means of lessening tension 
for the patient to a marked degree. Time, 
of course, is an essential element. 

The concluding chapter is a real high 
light for patients with this illness. It deals 
with many of their accompanying problems 
in a most practical and helpful way and 
ends with the locations of the migraine 
clinics situated throughout England. 



Medicine for Nurses, 10 ed., by W. Gordon 
Sears, M.D. (Lond.), M.R.C.P. (Lond.). 
549 pages. Toronto, The Macmillan 
Company of Canada Limited, 1966. 
Reviewed by Miss Thelma Pelley, director 
of nursing, Stratford General Hospital, 
Stratford, Ontario. 

This text presents a concise compilation 
of elementary data pertaining to the symp 
tomatology, diagnosis, and medical treat 
ment of diseases that are classified in ac- 



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Cancer 
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National Health and Welfare, 
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Miller Photo Services, Toronto, 
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University of Guelph, p. 46 



THE CANADIAN NURSE 55 



books 



cordance with their relationship to parti 
cular body systems and/or functions. 

In the preface to this tenth edition of 
a text first published more than 30 years 
ago, the author states that he has "not 
materially altered the general plan or 
academic level of the contents." It is there 
fore understandable that the text will 
have limited relevance to any progressive 
program in nursing. The title of the text, 
and the author s introductory comment 
that the text is designed to assist nursing 
students to acquire the minimum know 
ledge of medical science required for the 
writing of the General Nursing Council 
examinations, suggests a simplified, in 
complete presentation of medical data. 

In a disease-oriented approach, the text 
does not place emphasis upon any explan 
ation of primary principles of medicine and 
their application to nursing practice. The 
limited scope of the presentation is illustrat 
ed by the limited introductory definitions 
of "medicine" and "health," which des 
cribe medicine as "the art and science 
of healing disease," and health as "the 
perfect structure of all organs and tissues 
of the body with a perfect performance of 
all their functions." These definitions do 



not express the broader concepts of pre 
ventive medicine and of the World Health 
Organization definition of health which 
implies not perfection but a relative state 
of well-being and effective personal and 
social functioning. 

The format of the text is a collection of 
brief, simplified definitions organized prim 
arily on a basis of the systems affected. 
It would seem that the format, approach, 
and content of the text tend to encourage 
memorization of given factual data rather 
than to stimulate a questioning attitude or 
an intelligent analysis and application of 
scientific principles to nursing practice. 

A further illustration of the limitations 
of the presentation is the fact that in the 
discussion of metabolism, the emphasis is 
upon disorders, with practically no refer 
ence to the normal processes of metabolic 
function. There are brief comments upon 
fluid needs but no reference to the phy 
siology and importance of electrolyte ba 
lance. 

It is submitted therefore that this text 
has little to offer the instructor, student 
or practitioner of nursing who has access 
to a wide selection from many compre 
hensive texts on pathology, physiology, and 
pharmacology. There is also a wide selec 
tion of medical nursing texts that assist the 
nurse to understand and apply the basic 
principles of medical, physical, and social 



sciences, which are indivisibly interrelated 
to the art and science of nursing. 

All nurses today are committed to an 
obligation to be learners, teachers, and prac 
titioners of the art of nursing. Therefore, 
the nurse of today needs the assistance of 
texts that provide intellectual stimuli and 
give an adequate illustration and explana 
tion of the correlation and the application 
of scientific facts and principles, which are 
the underlying rationale of the essential 
skills exercised in the practice of nursing. 



Introduction to Growth, Development 
and Family Life by Dorothy Ellen Bab- 
cock, R.N., B.S.N.E., M.S.N. 2d ed. 145 
pages. Toronto, The Ryerson Press, 1966. 
Reviewed by Denise Martin, clinical in 
structor, St. Elizabeth Hospital, Hum- 
boldt, Saskatchewan. 

This paperback text is divided into three 
parts: part one, Self Understanding; part 
two, Normal Child Development; and part 
three, Maturity. 

As stated in the preface, the book is 
intended for those engaged in Practical I 
Vocational Nursing. It is written in a very 
basic and informal style with considera 
tion given to basic principles and the ap 
plication of these principles to the care 
of patients. Each part is preceded by an 
overview and ended with a summary, dis- 



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56 THE CANADIAN NURSE 




MARCH 1967 



books 



cussion questions, and references. Through 
out the chapters there are many diagrams 
and illustrations. 

Part one, Self Understanding, summarizes 
the concepts of personality development 
and those factors that influence its develop 
ment. The "iceberg" phenomenon is dia 
gramed and explained. 

Major developmental milestones and the 
basic physical and emotional needs of the 
individual at various age levels comprise 
part two. Each chapter has a catchy head 
ing, eg., "Jet Age Between One and Five 
Years." The same pattern is carried through 
to part three, Maturity. 

The book fulfills the author s intention 
of preparing a book, on an introductory 
level, for the practical nurse and of doing 
this in an interesting style. 

Educational Psychology by S.R. Laycock 
and B.C. Munro. 470 pages. Toronto, 
The Copp Clark Publishing Company, 
1966. 

Reviewed by Mrs. Frederica Heasman, 
R.R. #1, Camlachie, Ontario. 

Writers of applied introductory texts 
face a number of hazards for they must 
try to introduce a subject to students who 
do not have the requisite background knowl 
edge. Hopefully, the day will come when 
student teachers have a background of phi 
losophy, sociology, psychology, growth and 
development, etc., before they try to for 
mulate ideas about teaching. 

Some authors writing for students with 
limited backgrounds resort to admonish 
ing, eg., "you must accept..." or to offer 
ing simple solutions to complex questions, 
eg., "the best way is to . . ." Others offer 
much detail, obscuring the viewpoint they 
seek to express. 

A need exists for these texts and will 
continue as long as school teachers are 
being prepared in short programs in 
teachers colleges, and nursing specialists in 
education, supervision, and public health 
are offered postgraduate courses of one 
academic year. 

This text deserves wide recognition. It 
has avoided the pitfalls and contributes 
positively to an understanding of learning. 
Some of its strengths are: 1. The role of 
the teacher as outlined is warm, humane, 
and creative. Differences in students, 
teachers, and approaches to learning are 
supported, and statements made are based 
on well-chosen references. 2. A skillful selec 
tion of the material presented has resulted 
in a well-organized text written in pleasant 
English. 3. A variety of approaches to 
problems of teaching are outlined as exam 
ples of creative thinking rather than as 

MARCH 1967 



solutions. A basis for evaluation is sug 
gested and is integrated throughout the text 
in such a way that evaluation is presented 
as one process of learning. 4. It would 
be difficult for a person using this text to 
avoid going on to further reading in the 
areas considered as the approach is broad 
and the references are well used. 

This text would be of value for beginning 
teachers in nursing schools and for public 
and occupational health nurses. It could 
also help the experienced teacher who is 
feeling "dried up" or discouraged. 

It is a pleasant experience to read this 
book. The authors sincerity, enthusiasm, 
and respect for learners remains undiminish- 
ed after a lifetime of teaching. 

The Nursing Clinics of North America, 

vol. 1, no. 3, September 1966. June S. 
Rothberg, guest editor. Chronic Disease 
and Rehabilitation. 533 pages. A W.B. 
Saunders publication, available in Canada 
from McAinsh & Co. Ltd., of Toronto 
and Vancouver. 

Reviewed by Mrs. J. Peitchinis, associate 
professor, School of Nursing, University 
of Western Ontario, London, Ontario. 

Twenty nursing specialists contribute 17 
papers to this "Symposium on Chronic 
Disease and Rehabilitation," which prob 
ably does provide, as the guest editor hoped 
it would, valuable new insight and specific 
suggestions for nurses practicing in all set 
tings. 

The reviewer concurs with those authors 
who perceive many of the assumptions 
and practices discussed in the symposium 
to be applicable and imperative in all nur 
sing: there are rehabilitative aspects in the 
care of most patients, and one looks 
forward to the time when all nursing 
practice is directed toward them, so that 
the adjective rehabilitative becomes un 
necessary. The reviewer prefers the term 
long-term illness or disability employed by 
many of the contributors to those of chronic 
disease or disability used in the subtitle, 
and by some of the authors. 

The symposium sets out many of the 
basic assumptions underlying "rehabilitative 
nursing." It discusses the assessment of 
"patient need," approaches to working ef 
fectively with patients, and means for co 
ordinating all the services of the health 
team. In some papers the nurse is seen as 
the team leader. The role of the clinical 
nursing specialist in a rehabilitation center 
is described, and possibilities for nursing in 
industrial health settings are suggested. Not 
only is consideration given to the care of 
patients with particular long-term illnesses, 
but also to the process of aging, and to re 
habilitation of psychiatric and pediatric 
patients. There are numerous illustrations 
and patient studies to facilitate the reader s 
understanding; proposals for teaching re 
habilitative care to nonprofessional person 
nel are also presented. 



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of the chair and hooked together. When this 
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THE CANADIAN NURSE 57 



films 



Fire Safety 

They Called It Fireproof was produced 
in 1963 by the National Film Board. In the 
film, a coroner s inquest investigates the 
causes of a fire that took the lives of 
two patients in a supposedly "fireproof 
hospital. It shows how every individual in 
the hospital has a responsibility for safety- 
consciousness and constant vigilance. 

The film is an excellent one for all levels 



of hospital personnel, and should be shown 
in all schools of nursing and be used ex 
tensively in inservice education programs. 

The 28-minute, color, sound picture re 
ceived an award from the (USA) National 
Committee on Films for Safety. It is avail 
able on loan for a nominal service charge 
from the regional office of the National 
Film Board, or from the Canadian Film 
Institute, 1762 Carling Ave.. Ottawa 13. 

Community Health 

A useful film for student nurses learning 
about community and public health pro 
grams might be A Day in the Life of a 



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general feeling of well-being. It lets you walk on the entire 
bottom of your foot instead of just the heel and ball. This 
allows you to walk and stand longer without strain. 
For the name of your nearest Air Step dealer, write Air Step 
Division, Brown Shoe Company of Canada, Ltd., Perth, 
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Public Health Nurse. This film was prepar 
ed for television audiences and centers 
around the South Okanagan Health Unit in 
Kelowna, B.C. It shows some of fhe special 
services offered in the health department. 
It also illustrates some of the facilities 
for consultation and service from the staff 
of the provincial mental health services. 

The film can be obtained from the Cana 
dian Film Institute, 1762 Carling Ave., 
Ottawa 13, or from your provincial film 
library. The black and white film was 
produced in 1963 and runs for 12 minutes. 



Prices quoted are Suggested Retail Prices. 

Air Step Division, Brown Shoe Company of Canada Ltd., Perth, Ontario 
58 THE CANADIAN NURSE 



accession list 



Publications in this list of material 
received recently in the CNA library are 
shown in language of source. The majority 
(reference material and theses, indicated 
by R excepted) may be borrowed by CNA 
members, and by libraries of hospitals and 
schools of nursing and other institutions. 
Requests for loans should be made on the 
"Request Form for Accession List" (page 
60) and should be addressed to: The 
Library, Canadian Nurses Association, 
50 The Driveway, Ottawa 4, Ontario. 

BOOKS AND DOCUMENTS 

1. Australasian hospital directory and 
nurses year book 1966. Compiled and an 
notated by A.L. Hart. Sydney, N.S.W., 
New South Wales Nurses Assoc., 1966. 
185p. R 

2. Canadian annual review, 1965. Edit 
ed by John Saywell. Toronto, University 
of Toronto Press, 1966. 569p. R 

3. Child psychiatry. Ottawa, Canadian 
Psychiatric Association Journal, vol. 10, 
no. 5, October 1965. p. 423-443. 

4. Comparisons of intensive nursing 
service in a circular and a rectangular unit; 
Rochester Methodist Hospital, Rochester 
Minn., by Madelyne Sturdavant. Chicago, 
American Hospital Association, 1960. 
219p. 

5. Examinations and their place in med 
ical education and educational research. 
Edited by John P. Hubbard. Evanston 111., 
Association of American Medical Colleges, 
c!966. 69p. (Journal of Medical Education, 
vol. 41, no. 7, pt. 2, July 1966.) 

6. Factors influencing continuity of 
nursing service by Louise C. Smith. Study 
sponsored by National League for Nursing; 
directed by Institute of Research and Ser 
vice in Nursing Education, Teachers Col 
lege, Columbia University. New York, 
NLN, 1962. 139p. 

7. Handbook for the night super 
visor in the small hospital by Sister M. 
Virginia Clare. St. Louis, Catholic Hospital 
Association, 1963. lOOp. 

8. Higher education in a changing 
Canada; symposium presented by Royal 

MARCH 1967 



accession list 



Society of Canada in 1965. Edited by J.E. 
Hodgetts. Toronto, Published for the 
Society by University of Toronto Press, 

1966. 90p. 

9. Horizons unlimited; a handbook des 
cribing rewarding career opportunities in 
medicine and allied fields. Chicago, Amer 
ican Medical Association, c!966. 130p. 

10. How to find out; a guide to sources 
of information for all arranged by the 
Dewey Decimal Classification. Edited by 
G. Chandler. 2d ed. London, Pergamon, 
c!963. 198p. 

1 1 . Manual of hospital planning pro 
cedures. Chicago, American Hospital As 
sociation, 1966, c!958. 72p. 

12. The nursing clinics of North Amer 
ica, v. 1, no. 4. December, 1966. Philadel 
phia, Saunders. 209p. Contents: Sympo 
sium on the nurse and the new machinery. 
Ruby M. Harris, guest editor. Symposium 
on mental retardation, Kathryn Barnard, 
guest editor. 

13. Occasional paper 1:0. 64, Ottawa, 
Canadian Library Association, 1966. 2 pts. 
pt. 1. Canadian books, pamphlets and do 
cuments on gerontology in the Library of 
Parliament, pt. 2. Articles on aging indexed 
in Canadian periodical index 1947-1965, 
excerpted by Joan O Rourke. 

14. The operation of state hospital 
planning and licensing programs by G. Hil 
ary Fry. Chicago, American Hospital As 
sociation, c!965. 134p. 

15. Personal and vocational relation 
ships of the practical nurse by Marion 
Keith Stevens. Philadelphia, Saunders, 1967. 
258p. 

16. Pharmacology for practical nurses 
2d. ed. by Mary Kaye Asperheim. Philadel 
phia, Saunders, 1967. 163p. 

17. The Planning of change; readings 
in the applied behavioral sciences edited 
by Warren G. Bennis and Kenneth D. 
Benne and Robert Chin. New York, Holt, 
Rinehart and Winston, 1964, c!961. 289p. 

18. Psychology of human behavior for 
nurses, 3d ed. Lorraine Bradt Dennis. Phi 
ladelphia, Saunders, 1967. 289p. 

19. Psychology of human behavior for 
nurses, 3d ed. Instructors guide, by Lor 
raine Bradt Dennis. Philadelphia, Saunders, 

1967. llOp. 

20. The sister as a clinical specialist by 
Sister Leon Douville and Sister Marilyn 
Emminger. St. Louis, Conference of Catho 
lic Schools of Nursing, 1966. 126p. 

21. Skills that build executive success. 
Boston, Graduate School of Business Ad 
ministration Harvard University, 1964. 
121p. (Selections from Harvard Business 
Review.) 

22. A sociological framework for patient 
care. Edited by Jeannette R. Folta and Edith 

MARCH 1967 



S. Deck New York, Wiley, c!966. 418p. 

23. A study of arbitration decisions by 
Carl Hamilton. Toronto, United Steel- 
workers of America, 1966. 84p. 

24. Your health and you by H.P. 
Simonson and E.A. Hastie and H.A. 
Dorothy. Toronto, Macmillan, c!966. 
153p. 

PAMPHLETS 

25. A brief to Committee on the Heal 
ing Arts. Toronto, Registered Nurses As 
sociation of Ontario. 1966. 27p. 

26. Enrolment in Canadian universities 



and colleges to 1976/77; 1966 projection, 
by Edward F. Sheffield. Ottawa, Associa 
tion of Universities and Colleges, 1966. 
20p. 

27. An index of care by J.A.K. Mac- 
Donell and G.B. Murray. Ottawa, Medical 
Services J. 31:499-517, Sep. 1965. Reprint. 

28. Job descriptions. St. John s, Asso 
ciation of Registered Nurses of Newfound 
land, 1966. 16p. 

29. Joint statement on non-nursing acti 
vities carried out by nursing personnel in 
some hospitals. Vancouver, British Colum 
bia Hospitals Association and Registered 



DANDRUFF 
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II 



DANDRUFF 
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You won t see this in your hospital 



We re not trying to fool you. 

We re making a point! 

That dandruff is a serious medical 
problem and the only truly effective 
treatment is the medical one Selsun 
by Abbott. 

Selsun clears up annoying, unsight 
ly dandruff in two or three treatments, 
(thoroughly effective in 92% to 95% 
cases reported 1 ). 

You use it like any shampoo. Works 
fast. Comes in a handy unbreakable 
bottle. Leaves your hair glistening. 



Really, there s no room for dandruff 
in your professional or social life. Use 
Selsun and get to the root of the 
problem. 

Precautions: Occasional sensitization 
of the neck and external ear may 
occur. Falling hair which may accom 
pany scalp treatment is usually due to 
an impoverished or diseased condition 
of the hair and scalp. 



1 Slinger, W. N.. and Hubbard, D. M., Treat 
ment of Seborrheic Dermatitis with a Shampoo 
Containing Selenium Disu/fide, Arch. Dermal. 
& Syph., 64:41, 1951. 

Trademark registered 

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THE CANADIAN NURSE 59 



accession list 



Nurses Association of British Columbia 
Joint Committee, 1966. 6p. 

30. A list of schools of nursing in 
Ontario and minimum education require 
ments for entrance. Toronto, Ontario Hos 
pital Association, 1966. 30p. 

3 1 . Problem areas in the scientific, 
engineering and nursing professions by 
Garnet T. Page. Montreal 1963. 9p. 

32. Survey of salaries and employment 
conditions in nonfederal psychiatric hos 
pitals. June 1, 1965. New York, American 
Nurses Association. Research and Statistics 
Unit, 1966. 31 p. 

33. Tentative draft for 1966-67 of the 
policies and procedures of accreditation of 
the Dept. of Baccalaureate and Higher 
Degree Programs of the National league 
for Nursine. rev. New York, National 
League for Nursing. Dept. of Baccalaureate 
and Higher Degree Programs, 1966. 20p. 

34. Theorie et pratique du case work 
par Gordon Hamilton. Paris, Comite fran- 
?ais de service social et d action sociale, 
1965. 294p. 

35. To make a good assignment by 
Laura Jean Ott. New York, National 
League for Nursing. Dept. of Hospital 
Nursing, 1963. 21 p. 



GOVERNMENT DOCUMENTS 
Canada 

36. Bureau federal de la statistique. 
Annuaire du Canada; ressources, histoire, 
institutions et situation economique et so 
ciale du Canada. Ottawa, Imprimeur de la 
Reine, 1966. 1302p. 

37. Dept. of Labour. Legislation 
Branch. Developments in the enactment 
and administration of labour laws in Cana 
da; August, 1965-September, 1966. Ottawa, 
1966. 67p. 

38. Dept. of National Health and Wel 
fare. Emergency Health Services. Emer 
gency hospital operating manual 1966. Ot 
tawa, Queen s Printer, 1966. 102p. 

39. Ministere de la Sante Nationale et 
du Bien-etre Social. Services de Sante 
d Urgence. La section du nursing. Biblio 
graphic se rapportant au nursing d urgence. 
Ottawa, 1965. 30p. 

40. Ministere de la Sante Nationale et 
du Bien-etre Social. Services de Sante d Ur 
gence. Soins medicaux en cas de desastre; 
collection d articles, Ottawa, 1965. 135p. 

Nova Scotia 

41. Dept. of Labour. Economics and 
Research Division. Wage rates and hours 
of labour in Nova Scotia. Halifax, 1966. 
226p. 

United States 

42. Dept. of Health, Education and 



Welfare. Public Health Service. Admini 
strative aspects of hospital central medical 
and surgical supply services. Washington, 
1966. 37p. 

43. . A manual for hospital cen 
tral medical and surgical supply services. 
Washington, 1966. 106p. 

44. Dept. of Labour. Bureau of Labour 
Statistics. Major collective bargaining agree 
ments; arbitration procedures. Washington, 
U.S. Govt. Print. Off., 1966. 167p. 

45. . Major collective bargaining 

agreements; management rights and union- 
management co-operation. Washington, 
U.S. Govt. Print. Off., 1966. 69p. 

46. National Center for Health Statistics. 
Report of the United States delegation to 
the International Conference for the Eighth 
Revision of the International Classification 
of Diseases. Geneva, July 6-12, 1965. 
Washington, U.S. Govt. Print. Off, 1966. 

STUDIES DEPOSITED IN CNA REPOSITORY 
COLLECTION 

47. Senior nursing students career plans 
and their knowledge of and preparation for 
selected positions in nursing by Sister Loret- 
ta Morin. Washington, 1966. Thesis 
(M.Sc.N.) Catholic University of Amer 
ica. 62p. R 

48. Survey of schools of nursing in the 
province of Nova Scotia compiled by Sister 
Clare Marie. Halifax, Registered Nurses 
Association of Nova Scotia, 1966. 20p. R 



Request Form for "Accession List" 
CANADIAN NURSES ASSOCIATION LIBRARY 



Send to: 

LIBRARIAN, Canadian Nurses Association, 50 The Driveway, Ottawa 4, Ontario. 

Please lend me the following publications, listed in the 

Canadian Nurse, or add my name to the waiting list to receive them when available: 

Short title (for identification) 



issue of The 



Item 
No. 



Author 



Requests for loans will be filled in order of receipt. 

Reference and restricted material must be used in the CNA library. 



Borrower 

Position 

Address 

Date requested 



60 THE CANADIAN NURSE 



MARCH 1967 



classified advertisements 



ALBERTA 



ALBERTA 



BRITISH COLUMBIA 



NIGHT SUPERVISOR, R.N. AND MEDICAL HEAD 
NURSE for 90-bed active treatment hospital in the 
City of Wetaskiwin, situated midway between Ed 
monton and Red Deer. Residence accommodation 
available, excellent salary ranges and fringe benefits 
in effect, as well as payment for prior experience. 
Apply to: Director of Nursing, Municipal Hospital, 
Wetaskiwin, Alberta. 1-96-1 

Registered Nurses (5) required (summer relief or per 
manent posts} for May 1967. The Peace River Municipal 
Hospital, Alberta, was built 5 years ago and has a 
complement of 70 beds. Starting salary for 1966 
$370. New salary scales expected for 1967. Peace 
River is a progressive town and a beauty spot on the 
Prairies. Apply to: The Director of Nursing for fuller 
particulars. Peace River Municipal Hospital, Peace 
River, Alberta. 1-69-1 

REGISTERED NURSES FOR GENERAL DUTY (WANTED) 

for a 37-bed General Hospital. Salary $380 - $440 
per month. Commencing with $375 with 1 year and 
$390 with 3 years practical experience elsewhere. 
Full maintenance available at $35 per month. Pen 
sion plan available, train fare from any point in 
Canada will be refunded after 1 year employment. 
Hospital located in a town of 1,100 population, 85 
miles from Capital City on a paved highway. 
Apply to: Two Hills Municipal Hospital, Two Hills, 
Alberta. 1-88- 1 

NURSES FOR GENERAL DUTY in active 30-bed hospital, 
recently constructed building. Town on main line of 
the C.P.R. and on Number 1 highway, midway 
between the cities of Calgary and Medicine Hat. 
Nurses on staff must be willing and able to take re 
sponsibility in all departments of nursing, with the 
exceptions of the Operating Room. Recently renovated 
nurses residence with all single rooms situated on 
hospital grounds. Apply to: Mrs. M. Hislop, Adminis 
trator and Director of Nursing, Bassano General Hos 
pital, Bossano, Alberta. 1-5-1 



ADVERTISING 
RATES 

FOR ALL 
CLASSIFIED ADVERTISING 

$10.00 for 6 lines or less 
$2.00 for each additional line 

Rates for display 
advertisements on request 

Closing date for copy and cancellation is 
6 weeks prior to 1st day of publication 
month. 

The Canadian Nurses Association has 
not yet reviewed the personnel policies 
of the hospitals and agencies advertising 
in the Journal. For authentic information, 
prospective applicants should apply to 
the Registered Nurses Association of the 
Province in which they are interested 
in working. 



Address correspondence to: 

The 

Canadian 
Nurse 




50 THE DRIVEWAY 
OTTAWA 4, ONTARIO. 



General Duty Nurses for active, accredited, well- 
equipped 64-bed hospital in growing town, population 
3,500. Salaries range from $380-$440 commensurate 
with experience, other benefits. Nurses residence. 
Excellent personnel policies and working conditions. 
New modern wing opened this year. Good commu 
nications to large nearby cities. Apply Director of 
Nursing, Brooks General Hospital, Brooks, Alberta. 

1-13-1B 

GENERAL DUTY NURSES for modern 25-bed hos 
pital on Highway No. 12, East-Central Alberta. 
Salary range $380 to $440. (including a regional 
differential). New staff residence. Full maintenance 
$35. Personnel policies as per AARN. Apply to the: 
Director of Nursing, Coronation Municipal Hospital, 
Coronation, Alberta. Tel.: 578-3803. 1-25-JB 

GENERAL DUTY NURSES for 64-bed, active treatment 
hospital, 35 miles South of Calgary. Salary range 
$360 - $420. Living accommodation available in 
separate residence if desired. Full maintenance in 
residence $35 per month. 30 days paid vacation after 
12 months employment. Please apply to: The Director 
of Nursing, High River Municipal Hospital, High 
River, Alberta. 1-46-1 

GENERAL DUTY NURSES: Modern 26-bed hospital 
close to Edmonton. 3 buses daily. Salary $360.00 to 
$420.00 per month commensurate with experience. 
Residence available $35.00 per month. Excellent 
personnel policies. Apply: Director of Nursing, 
Mayerthorpe Municipal Hospital, Mayerthorpe, Al 
berta. 1-61-1 

GENERAL DUTY NURSES for 94-bed General Hospital 
located in Alberta s unique Dinosaur Badlands. $360 
- $420 per month, 40 hour week, 3! days vacation, 
pension. Blue Cross, M.S.I, and generous sick time. 
Apply to: Miss M. Hawkes, Director of Nursing, Drum- 
heller General Hospital, Drumheller, Alberta, 1-31-2 A 



BRITISH COLUMBIA 



Operating Room Hood Nurse ($464 - $552), General 
Duty Nurses (B.C. Registered $405 -$481, non-Regis 
tered $390J for fully accredited 113-bed hospital in 
N.W. B.C. Excellent fishing, skiing, skating, c-rling 
and bowling. Hot springs swimming nearby. Nurses 
residence, room $20 per month. Cafeteria meals. 
Apply: Director of Nursing, Kitimat General Hospital, 
Kitimat, British Columbia. 2-36-1 

Royal Jubilee Hospital, Victoria, B.C., invites B.C. 
Registered Nurses (or those eligible) to apply for 
positions in Medicine, Surgery and Psychiatry. Apply 
to : Director of Nursing. Victoria, British Columbia. 

2-76-4A 

A Medical-Surgical Nursing Instructor, with University 
preparation, for a 450-bed hospital with a school of 
nursing, 150 students. Apply: Sister Mary Ronalda, 
M.N., Director, School of Nursing, St. Joseph s Hos 
pital, Victoria, B.C. 2-76-50 

PSYCHIATRIC CLINICAL INSTRUCTOR required by 
ROYAL INLAND HOSPITAL, KAMLOOPS, British Col 
umbia. For further information write to: Director of 
Nursing Education, Royal Inland Hospital, Kam- 
loops, B.C. 2-81-2 

REGISTERED, GRADUATE NURSES AND PRACTICAL 

NURSES for modern 70-bed accredited hospital on 
Vancouver Island, B. C. Resort area home of the 
tyee salmon four hours travelling time to City of 
Vancouver. RNABC policies and Union Contract in 
effect. Residence accommodation available. Direct 
enquiries to: Director of Nursing, Campbell River and 
District General Hospital, Campbell River, British 
Columbia. 2-9-1 A 

Graduate Nurses of Christian conviction: (Urgently 
wanted). Willing to serve for one year or more in 
Mission Hospitals in the outlaying areas of Canada. 
Immediate need at Queen Charlotte Islands, Bella 
Bella, Hazel ton and Burns Lake in British Columbia 
and at Baie Verte, in Newfoundland. Salary and 
working conditions as agreed between Reg. Nurses 
Association and Hospital Association of Province con 
cerned. Please contact: Board of Home Missions of 
The United Church of Canada, 85 St. Clair Ave., E., 
Toronto 7, Ontario, or Dr. W.D. Watt, 6762 Cypress 
Street, Vancouver 14, B.C. 2-73-25 

GRADUATE NURSES for 24-bed hospital, 35-mi. from 
Vancouver, on coast, salary and personnel prac 
tices in accord with RNABC. Accommodation availa 
ble. Apply: Director of Nursing, General Hospital, 
Squamish, British Columbia. 2-68-1 



B.C. R.N. for General Duty in 32 bed General Hospi 
tal. RNABC 1967 salary rate $390 - $466 and fringe 
benefits, modern, comfortable, nurses residence in 
attractive community close to Vancouver, B.C. For 
application form write: Director of Nursing, Fraser 
Canyon Hospital, R.R. 1, Hope, B.C. 2-30-1 

GENERAL DUTY NURSES (Two) for active 66-bed 
hospital, with new hospital to open in 1968. 
Active in-service programme. Salary range $372 to 
$444 per month. Personnel policies according to 
current RNABC contract. Hospital situated in beauti 
ful East Kpotenays of British Columbia, with swim 
ming, golfing and skiing facilities readily available. 
Apply to: The Director of Nursing, St. Eugene Hos 
pital, Cranbrook, British Columbia. 2-15-1 

General Duty Nurses for active 30-bed hospital. 
RNABC policies and schedules in effect, also North 
ern allowance. Accommodations available in res 
idence. Apply: Director of Nursing, General Hospital, 
Fort Nelson, British Columbia. 2-23-1 

General Duty Nurses for new 30-bed hospital 
located in excellent recreational area. Salary and 
personnel policies in accordance with RNABC. Com 
fortable Nurses home. Apply: Director of Nursing, 
Boundary Hospital, Grand Forks, British Columbia. 

2-27-2 

General Duty Nurses (2 immediately) for active, 
26-bed hospital in the heart of the Rocky Mountains, 
90 miles from Banff and Lake Louise. Accommoda 
tion available in attractive nurses residence. Apply 
giving full details of training, experience, etc. to: 
Administrator, Windermere District Hospital, Inver- 
mere, British Columbia. 2-31-1 

General Duty Nurses for new 37-bed hospital. 
Located in Southwest British Columbia. Salary and 
personnel policies in accordance with RNABC. $390 
to $466. Accommodation available in residence. Apply 
to: Director of Nursing, Nicola Valley General Hos 
pital, Box 129, Merritt, British Columbia. 2-41-1 

General Duty Nurses for well-equipped 80-bed Gener 
al Hospital in beautiful inland Valley adjacent Lake 
Kathlyn and Hudson Bay Glacier. Initial salary $387. 
Maintenance $60, 40-hour 5 day week, vacation with 
pay, comfortable, attractive nurses residence, 
Boating, fishing, swimming, golfing, curling, skating, 
skiing. Apply to: Director of Nursing, Bylkley Valley 
District Hospital, P.O. Box No. 370, Smithers, British 
Columbia. 2-67-1 

GENERAL DUTY NURSES Salary non B.C. 
registered $375 per month B.C. registered $390- 
$466, depending on experience. RNABC policies in 
effect. Nurses residence available. Group Medical 
Health Plan. All winter and summer sports. Apply: 
Director of Nursing, Cariboo Memorial Hospital, Wil 
liams Lake, British Columbia. 2-80-1 A 

General Duty O. R. and experienced Obstetrical 
Nurses for modern, 1 50-bed hospital located in the 
beautiful Fraser Valley. Personnel policies in ac 
cordance with RNABC. Apply to: Director of Nursing, 
Chilliwack General Hospital, Chilliwack, British Co 
lumbia. 2-13-1 

General Duty and Operating Room Nurses for 70-bed 
Acute General Hospital on Pacific Coast. B.C. Regis 
tered $390 - $466 per month (Credit for experience). 
Non B.C. Registered $375 Practical Nurses B.C. Li 
censed $273 -$311 per month. Non Registered $253- 
$286 per month. Board $20 per month, room $5.00 per 
month. 20 paid holidays per year and 10 statutory 
holidays after 1 year. Fare paid from Vancouver. 
Superannuation and medical plans. Apply: Director of 
Nursing, St. George s Hospital, Alert Bay, British 
r-^i i o.i A 



. ursing, 
Columbia. 



2-2-1 A 



MARCH 1967 



Genera Duty, Operating Room and Experienced 

Obsfetrtcaf Nurses for 434-bed hospital with school 
of nursing. Salary: $372-$444. Credit for past ex- 
perienca and postgraduate training. 40-hr, wk. Stat 
utory holidays. Annual increments; cumulative sick 
leave; pension plan; 28-day $ annual vacation; B.C. 
registration required. Apply: Director of Nursing, 
Royal Columbian Hospital, New Westminster, British 
Columbia. 2-73-13 

GENERAL DUTY NURSES for 109-bed hospital in 
expanding Northwestern British Columbia City. Salary 
$405 to $481 for B.C. Registered Nurses with recogni 
tion for experience. RNABC contract in effect. Gradu 
ate Nurses not registered in B.C. paid $390. Benefits 
include comprehensive medical and pension plans. 
Travel allowance up to $60 refunded after one 
year s service. Comfortable modern residence accom 
modation at $15 per month, meals at cost. Apply to: 
Director of Nursing, Prince Rupert General Hospital, 
551 -5th Avenue East, Prince Rupert, B.C. 2-58-2A 

THE CANADIAN NURSE 61 



BRITISH COLUMBIA 



General Duty and Operating Room Nurses for 

modern 450-bed hospital with School of Nursing. 
RNABC policies in effect. Credit for past experience 
and postgraduate training. British Columbia registra 
tion required. For particulars write to: the Director of 
Nursing Service, St. Joseph s Hospital, Victoria, British 
Columbia. 2-76-5 

Graduate Nurse required for 26-bed hospital in sunny 
B.C. interior, salary $410 per month with 28 days 
annual vacation plus 10 paid stats. Full room and 
board in TV equipped residence $50 per month with 
free uniform laundry. Apply: Director of Nursing, 
Princeton General Hospital, Princeton, B.C. 2-59-1 

GRADUATE NURSES: Join us at the booming center 
of B.C. II Surrounded by 50 beautiful lakes with 
excellent boating, swimming, fishing plus all winter 
sports. On hour s drive from Prince George, the 
fastest growing city in Canada. Active 44-bed hos 
pital and modern nurses residence over looking the 
picturesque Nechako River. Starting salary $372 - $408, 
recognition given for experience. Health and pension 
plan, 40-hr, week and 4 weeks vacation. Write to: 
Mrs. M. Grant, Director of Nursing, St. John Hospital, 
Vanderhoof, British Columbia. 2-74-1 

Graduate Nurses for General Duty in modern 188- 
bed hospital in city (20,000) on Vancouver Island. 
Personnel policies in accordance with RNABC poli 
cies. Starting salary for R.N. $372. per month. Apply 
to: Director of Nursing, Regional General Hospital, 
Nanaimo, British Columbia. 2-46-1 



ONTARIO 



ONTARIO 



MANITOBA 




Registered Nurse: Required for 50-bed general hospital 
in Fort Churchill, Manitoba. Starting salary $500 per 
month. Return fare from Winnipeg refunded after one 
year s service. For particulars write to: Director of 
Nursing, General Hospital, Fort Churchill, Manitoba. 

3-75-1 

Registered Nurse for 18-bed hospital at Vita Manitoba, 
70 miles from Winnipeg. Daily bus service. Salary 
range $380 $440, with allowance for experience. 
40 hour week, 10 statutory holidays, 4 weeks paid 
vacation after one year. Full maintenance available 
for $50 per month. Apply: Matron, Vita District 
Hospital, Vita, Manitoba. 3-68-1 

Registered Nurses and Licensed Practical Nurses for 

232-bed Children s Hospital, with school of nursing; 
active teaching center. Positions available on all 
services. Apply: Director of Nursing, Children s Hos 
pital, Winnipeg 3, Manitoba. 

Registered Nurse for General Duty in 20-bed hospital. 
Salary range $405 - $490 per month. Living accom 
modations available. Generous personnel policies. 
Apply: Director of Nursing, Reston Community Hos 
pital. Reston, Man. 3-46-2 



General Duty Nurses for 100-bed active treatment hos 
pital. Fully accredited. 50 miles from Winnipeg on 
Trans Canada Highway. Apply: Director of Nursing 
Service, Portage District General Hospital, Portage La 
Prairie, Manitoba. 3-45-1 



NOVA SCOTIA 

Director for School of Nursing: 50 students. Excellent 
working conditions. Apply to: M. Jean Hemsworth, 
Administrator, Glace Bay General Hospital, Glace 
Bay, Nova Scotia. 6-15-1 

Registered and Graduate Nurses for General Duty. 

New hospital with all modern conveniences, also, 
new nurses residence available. South Shore Com 
munity. Apply to: Superintendent, Queens General 
Hospital, Liverpool, Nova Scotia. 6-20-1 

Registered Nurses for 21 -bed hospital in pleasant 
community Eastern Shore of Nova Scotia. Apply: 
Superintendent, Eastern Shore Memorial Hospital, 
Sheet Harbour, Nova Scotia. 6-32-1 

62 THE CANADIAN NURSE 



Coordinator of Clinical Nursing Studies in the 
Bachelor of Science in Nursing Course: The School 

of Nursing, McMaster University, invites applications 
from persons with advanced qualifications in clinical 
nursing. The position is open for the 1967-1968 
session, with duties commencing July 1967. Please 
apply sending curriculum vifae and two references 
to : Director, School of Nursing, McMaster University, 
Hamilton, Ontario. 7-55-15 

REGISTERED NURSES (IMMEDIATELY) for a new 40- 

bed hospital. Nurses residence private rooms with 
bath $20 per month. Minimum salary $415 plus 
experience allowance, 4 semi-annual increments. 
Reply to: The Director of Nursing, Geraldton District 
Hospital, Geraldton, Ontario. 7-50-1A 

Algonquin Park camp for girls: Requires Registered 
Nurses. July and/or August. Single, under 50. Apply: 
Camp Tanamakoon, 24 Wilberton Road, Toronto 7, 
Ontario. HU. 1-3704. 7-133-72 

Registered Nurses and Registered Nursing Assistants 

are invited to make application to our 75-bed, 
modern General Hospital. You will be in the Vaca- 
tionland of the North, midway between the Lakehead 
and Winnipeg, Manitoba. Basic wage for Registered 
Nurses is $408 and for Registered Nursing Assistants 
is $285 with yearly increments and consideration for 
experience. Write or phone: The Director of Nursing, 
Dryden District General Hospital, DRYDEN, Ontario. 

7-26-1 A 

Registered Nurses and Registered Nursing Assistants 
for 83-bed General Hospital in French speaking com 
munity of Northern Ontario. R.N. s salary: $420 to 
$465/171,, 4 weeks vacation, 18 sick leave days and 
R.N.A. s salary: $300 to $340/m., 2 weeks vacation 
and 12 sick leave days. Unused sick leave are paid 
at 100 %. Rooming accommodations available in 
Town and meals served at the Hospital. Excellent 
personnel policies. Apply to: Director of Nursing, 
Notre-Dame Hospital, Hearst, Ontario. 7-58-1 

Registered Nurses and Registered Nursing Assistants. 

Starting Salary for R.N. is $415 and for R.N. A, is $300. 
Allowance for experience. Excellent fringe benefits. 
Write: Mrs G. Gordon, Superintendent, Nipigon Dis 
trict Memorial Hospital, Box 37, Nipigon, Ontario. 

7-87-1 

Registered Nurses and Registered Nursing Assistants 

for 160-bed accredited hospital. Starting salary $415 
and $285 respectively with regular annual incre 
ments for both. Excellent personnel policies. Resid 
ence accommodation available. Apply to: Director of 
Nursing, Kirkland & District Hospital, Kirkland Lake, 
Ontario. 7-67-1 

Registered Nurses and Registered Nursing Assistants 

for 123-bed accredited hospital. Starting salary $400 
and $255 respectively with regular increments for 
both. Usual fringe benefits. For full information, 
apply to: Director of Nursing, Duffer in Area Hos 
pital, Orangeviile, Ontario. Phone 941-2410. 7-90-1 

Registered Nurses and Registered Nursing Assistants: 

Applications are invited from R. N s and R. N. Ass ts. 
who are interested in returning to "nursing at the 
bedside" in a well-equipped General Hospital. Excel 
lent starting salaries and fringe benefits now. Further 
increase January t, 1967, Residence accommodation if 
desired. For full particulars write to: Director of 
Nursing, Sioux Lookout General Hospital, P. O. Box 
909, Sioux Lookout, Ontario. 7-119-1 A 



Registered Nurses for 34-bed hospital, min. salary 
$387 with regular annual increments to maximum 
of $462. 3-wk. vacation with pay; sick leave after 
6-mo. service. All Staff 5 day 40-hr, wk., 9 
statutory holidays, pension plan and other benefits. 
Apply to: Superintendent, Englehart & District Hos 
pital, Englehart, Ontario. 7-40-1 

Registered Nurses. Applications and enquiries are 
invited for general duty positions on the staff of the 
Manitouwadge General Hospital. Excellent salary 
and fringe benefits. Liberal policies regarding ac 
commodation and vacation. Modern well-equipped 
33-bed hospital in new mining town, about 250-mi. 
east of Port Arthur and north-west of White River, 
Ontario Pop. 3,500. Nurses residence comprises indi 
vidual self-contained opts. Apply, stating qualifica 
tions, experience, age, marital status, phone number, 
etc. to the Administrator, General Hospital, Mani 
touwadge, Ontario. Phone 826-3251 7-74-1 A 

Registered Nurses: Applications are invited for Gener 
al Duty Staff Nurses; Gross salary range: $362 to 
$422. Supervisory advancement opportunities. Resident 
accommodations available; Hospital situated in tourist 
town off Lake Huron. For further information write: 
Superintendent, Saugeen Memorial Hospital, South 
ampton, Ontario. 7-122-1 



PUBLIC HEALTH NURSES: B.C. Civil Service. Salary: 
$476-$580 per month, car provided. Interesting and 
challenging professional service with opportunities for 
transfer throughout beautiful B.C. Apply to: B.C. 
Civil Service Commission, 544 Michigan Street, 
VICTORIA, B.C. 
COMPETITION No. 67:57. 2-76-7 

Registered Nurses for 18-bed (expanding to 36 bed) 
General Hospital in Mining and Resort town of 5,000 
people. Beautifully located on Wawa Lake, 140 miles 
north of Sault Ste. Marie, Ontario. Wide variety of 
summer and winter sports including swimming, boat 
ing, fishing, golfing, skating, curling and bowling. 
Six churches of different faiths. Salaries comparable 
with all northern hospitals. Limited bed and board 
available at reasonable rate. Excellent personnel 
policies, pleasant working conditions. Apply to: 
Director of Nursing, The Lady Dunn General Hospital, 
Box 179, Wawa, Ontario. 7-140-1 B 

Registered Nurses and Registered Nursing Assistant*, 

for 100-bed General Hospital, situated in northern 
Ontario. Starting salary. Registered Nurses $390 per 
month. Registered Nursing Assistants $273 per month, 
shift differential, annual increment, 40 hour week, 
O. H. A. pension plan and group life insurance, 
O. H. S. C. and P. S. I. plans in effect. Accommoda 
tion available in residence if desired. For full par 
ticulars apply: The Director of Nurses, Lady Min to 
Hospital, Cochrcne, Ontario. 7-30-1 A 

Registered or Graduate Nurses, required for modern 
92-bed hospital. Residence accommodation $20 month 
ly. Overseas nurses welcome. Lovely old Scottish 
Town near Ottawa. Apply: Director of Nursing, The 
Great War Memorial Hospital, Perth, Ontario. 7-100-2 

Registered Nurses for General Duty in well-equipped 
28-bed hospital, located in growing gold mining 
and tourist area, north of Kenora, Ontario. Modern 
residence with individual rooms; room, board and 
uniform laundry only $50/m, 40-hr, wk., no split shift, 
cumulative sick time, 8 statutory holidays and 28 
day paid vacation after one year. Starting salary 
$430. Apply to: Matron, Margaret Cochenour Memo 
rial Hospital, Cochenour, Ontario. 7-29-1 

Registered Nurses for General Duty and Operating 
Room, in modern 100-bed hospital, situated 40 miles 
from Ottawa. Excellent personnel policies. Residence 
accommodation available. Apply to: Director of 
Nursing, Smiths Falls Public Hospital, Smiths Falls, 
Ontario. 7-120-2A 



Registered Nurses for General Duty in 100-bed hos 
pital, located 30-mi. from Ottawa, are urgently re 
quired. Good personnel policies, accommodation 
available in new staff residence. Apply: Director of 
Nursing, District Memorial Hospital, Winchester, On 
tario. 7-144-1 



Registered Nurses for General Duty and Operating 
Room in modern hospital (opened in 1956). Situated 
in the Nickel Capital of the world, pop. 80,000 
people. Salary $372 per mo., with annual merit 
increments, plus annual bonus plan, 40-hr, wk. Recog 
nition for experience. Good personnel policies. Assist 
ance with transportation can be arranged. Apply: 
Director of Nursing, Memorial Hospital, Sudbury, 
Ontario. 7-127-4 



General Duty Nurses for 66-bed General Hospital. 
Starting salary: $405/m. Excellent personnel policies. 
Pension plan, life insurance, etc., residence accom 
modation. Only 10 min. from downtown Buffalo. 
Apply: Director of Nursing, Douglas Memorial Hos 
pital, Fort Erie, Ontario. 7-45-1 

General Duty Nurses for active General 77-bed Hos 
pital in heart of Muskoka Lakes area: salary range 
$400 - $460 with consideration for previous experience; 
excellent personnel policies and fringe benefitsrnurses 
residence available. Apply to: Director of Nursing, 
Huntsville District Memorial Hospital, Huntsville, On 
tario. 7-59-1 

General Staff Nurses and Registered Nursing Assis 
tants are required for a modern, well-equipped General 
Hospital currently expanding to 167 beds. Situated in 
a progressive community in South Western Ontario, 30 
miles from Windsor-Detroit Border. Salary scaled to 




for turther Information TO: MISS Karncia /vicoee, p. 
Sc.N., Reg.N. Director of Nursing, Leamington District 
Memorial Hospital, Leamington, Ontario. 7-69-1 A 

OPERATING ROOM NURSES (2) for a fully ac 
credited 70-bed General Hospital. For Operating 
Room Duty. Salary according to experience. Apply to: 
O.R. Supervisor, Penetanguishene General Hospital, 
Penetanguishene, Ontario. 7-99-2 

MARCH 1967 



ONTARIO 



SASKATCHEWAN 



General Doty Nurses for 100-bed modern hospital. 
Southwestern Ontario, 32 mi. from London. Salary 
commensurate with experience and ability; $398/m 
basic salary. Pension plan. Apply giving full par 
ticulars to: The Director of Nurses, District Memorial 
Hospital, Tillsonburg, Ontario. 7-131-1 



General Duty Nurses, Certified Nursing Assistants & 
Operating Room Technician (1) for new 50-bed hos 
pital with modern equipment, 40-hr, wk., 8 statutory 
holidays, excellent personnel policies & opportunity 
for advancement. Tourist town on Georgian Bay. 
Good bus connections to Toronto. Apply to: Director 
of Nurses, General Hospital, Meaford, Ontario. 7-79-1 



GRADUATE NURSES (2) Girl s private camp; 175 
campers, 6-16, Located at Sundridge, Ontario, 175 
miles north of Toronto. Camp dates June 30 to 
August 24. Salary not less than $400 for camp 
season. Some help with transportation if coming from 
a distance. Write: Mrs. John W. Gilchrist, 6-A Wynch- 
wood Park, Toronto 4, Ontario. 7-133-75 



Graduate Nurses for staff positions including O. R. 

requ r red for 8 1 -bed hosp ita I. Residence accommoda 
tion available. Pleasant Lakeside town within 45 miles 
of Stratford and 60 miles of London. Apply: Director 
of Nursing, Alexandra Marine and General Hospital, 
Godench, Ontario. 7-51-1 



Public Health Nurses (Bilingual) for rural health unit. 
Minimum salary: $5,200 with annual increments. Al 
lowance for experience. Car allowance, pension plan, 
hospitahsation insurance, P.S.I. Apply to: Dr. R. G. 
Grenon, Director, Prescott and Russell Health Unit, 
P.O. Box 273, L Orignal, Ontario. 7-73-14 

PUBLIC HEALTH NURSES for scenic urban and rural 
health unit, close to the Capital City in the Upper 
Ottawa Valley Tourist Area. Good summer and 
winter recreational facilities. Personnel policies pre 
sently under review. Direct enquiries to: Dr. R.V. 
Peters, Director, Renfrew County Health Unit, 169 
William Street, Pembroke, Ontario. 7-98-2 



Public Health Nurses for generalized programme in 
a County-City Health Unit, Salary schedule as of 
January 1, 1967, $5,100 to $6,100. 20 days vacation. 
Employer shared pension plan, P.S.I, and hosp ita I - 
ization. Mileage allowance or unit cars. Apply to : 
Miss Veronica O Leary, Supervisor of Public Health 
Nursing, Peterborough County-City Health Unit, P.O. 
Box 246, Peterborough, Ontario. 7-101 -4A 



PUBLIC HEALTH NURSE (Qualified) for generalized 
programme. Salary Range $5,200 - $6,400 according 
to experience. Salaries negotiated annually. Personnel 
Policies on request. Apply in writing to: Miss Beatrice 
Whalley, Supervisor of Public Health Nursing, Waterloo 
County Health Unit 109 Argyle St., S., Preston, Ontario. 

10-109-2 



Public Health Nurses for general programme. Salary 
range $5,100 to $6,300. Personnel policies include car 
expense, Omers and Canada pension plans, group 
life insurance, 50% of P.S.I, and hospital insurance, 
cumulative sick leave plan and liberal vacation. 
Apply to: Dr. G.L. Anderson, Director, The Lambton 
Health Unit, 333 George Street, Sarnia, Ontario. 

7-114-3 



QUEBEC 



NURSE for Children s Summer Camp, located near 
Ste. Ago the, Que., well equipped infirmary, private 
Jiving quarters, excellent facilities. Apply to: Mr. R. 
Lazanik, Pine Valley Camp, 5465 Queen Mary Road, 
suite 460, Montreal 29, Quebec. 9-47-67 



SASKATCHEWAN 



DIRECTOR OF NURSING for modern 24-bed active 
treatment hospital. Graduates in nursing administration 
or with experience will be given preference. Accommo 
dation available in nurses residence. Salary schedule 
will be based on the SRNA recommendations. Apply: 
Mr. R. Holinaty, Administrator, Wakaw Union Hospital, 
Wakaw, Saskatchewan. 10-131-1 A 

REGISTERED NURSES for 24-bed active treatment hos 
pital. Established personnel policies and pension plan. 
Salary range as per SRNA recommendations. Adjust 
ments to starting salary made for previous experience. 
Residence accommodation available at $43.50 per 
month. Apply: Mrs. Z. Johnson, Acting Director of 
Nursing, Wakaw Union Hospital, Wakaw, Saskatche 
wan. 10-131-1 



MATRON required for a 60-bed nursing home. Must be 
a registered nurse and capable of taking charge of 
intensive and Limited care patients. Duties to begin 
as soon as possible. Salary in accordance to schedule 
and experience. Apply to: SECRETARY-MANAGER, 
Estevan Regional Nursing Home, Estevan, Saskatche 
wan. T 0-32-2 



Registered Nurses for General Duty (2) in fully 
modern 27-bed hospital. Basic salary $400 per month. 
Personnel policies according to Sask. Reg. Nurses As 
sociation recommendations. New modern residence, 
excellent working conditions. Duties to commence 
when convenient. Apply to: Superintendent of Nursing 
Services. Kipling Memorial Union Hospital, Kipling, 
Saskatchewan. 10-59-1 

General Duty and Operating Room Nurses, also 
Certified Nursing Assistants for 560-bed University 
Hospital. Salary commensurate with experience and 
preparations. Excellent personnel policies. Excellent 
opportunities to engage in progressive nursing. Ap 
ply : Director of Personnel, University Hospital, Sas 
katoon, Saskatchewan. 10-1 16-4A 



UNITED STATES 



REGISTERED NURSES Southern California Op 
portunities available 368-bed modern hospital in 
Medical-Surgical. Labor and Delivery, Nursey, Oper 
ating Room and Intensive and Coronary Care Units. 
Good salary and liberal fringe benefits. Continuing 
inservice education program. Located 10 miles from 
Los Angeles near skiing, swimming, cultural and edu 
cational facilities. Temporary living accommodations. 
Apply: Director of Nursing Service, Saint Joseph 
Hospital, Burbank, California 91503. 15-5-63 

REGISTERED NURSES needed for rapidly expanding 
general hospital on the beautiful Peninsula near 
San Francisco. Outstanding policies and benefits, 
including temporary accommodations at low cost, 
health coverage, fully refundable retirement plan, 
liberal shift differentials, no rotation, exceptional 
in-service and orientation programs, unlimited sick 
leave accrual, unlimited vacation accrual, sick leave 
conversion to vacation, tuition reimbursement. Ex 
cellent salaries based on experience. Contact Person 
nel Administrator, Peninsula Hospital, 1783 El 
Comma Real, Burlingame, California 697-4061 . 

1 5-5-20 B 

Registered Nurses: The Los Angeles County General 
Hospital has opportunities in all clinical areas. We 
invite your enquiries about positions available in pre 
mature nursery, neuro-surgery, pediatrics, operating 
room and recovery room, as well as general medical 
or surgical words. Several specialty programs are 
planned for 1967. Starting salary with one year s ex 
perience in an accredited hospital is $591 per month, 
$624 after six months. Additional pay for a degree. 
Evening bonus approximately $60 per month. Night 
bonus $50. Living quarters available on hospital 
grounds for at least 90 days. We wiJI help you with 
California Registration. For further information, 
write: Mrs. Dorothy Easley, Box 1311 CN. Los Angeles 
County General Hospital, 1200 North State Street, Los 
Angeles, Colifornio 90033. 15-5-3 E 

REGISTERED NURSES Opportunities available at 
415-bed hospital in Medical-Surgical, Labor and 
Delivery, Intensive Care, Operating Room and Psy 
chiatry. No rotation of shift, good salary, evening 
and night differentials, liberal fringe benefits. 
Temporary living accommodations available. Apply: 
Miss Dolores Merrefl, R.N., Personnel Director, Queen 
of Angels Hospital, 2301 Bellevue Aevnue, Los 
Angeles 26, California. 15-5-3G 

REGISTERED NURSES SAN FRANCISCO Children s 
Hospital and Adult Medical Center hospital for men. 
women and children. California registration required. 
Opportunities in all clinical areas. Excellent salaries, 
differentials for evenings and nights. Holidays, vaca 
tions, sick leave, life insurance, health insurance and 
employer-paid pension-plan. Applications and details 
furnished on request. Contact Personnel Director, Chil 
dren s Hospital, 3700 California Street, San Francisco 
18, California. 15-5-4 



REGISTERED NURSES : Mount Zion Hospital and Me 
dical Center s increased salary scales now double our 
attraction for nurses who find they can afford to live 
by the Golden Gate. Expansion has created vacancies 
for staff and specialty assignments. Address enquiry 
to: Personnel Department, 1600 Divisadero Street, San 
Francisco, California 94115, An equal opportunity em 
ployer. 1 5-5-4 C 

Nurses for new 75-bed General Hospital. Resort 
area. Ideal climate. On beautiful Pacific ocean. 
Apply to: Director of Nurses, South Coast Com 
munity Hospital, South Laguna, California. 15-5-50 



DIRECTOR 

REGIONAL SCHOOL 
OF NURSING 

"KIRKLAND LAKE" 

Applications are invited for the 
position of Director of a new 
Regional School of Nursing to be 
established in Kirkland Lake with 
an annual enrollment of 30 
students encompassing five area 
hospitals. An excellent opportu 
nity to develop a program from 
the erection of the building to 
operating the school. 

Please direct enquiries to: 

The Secretary of the Steering 

Committee: 
R. J. Cameron, Administrator, 

KIRKLAND AND DISTRICT 
HOSPITAL 

Kirkland Lake, Ontario. 



UNITED STATES 



MARCH 1967 



General Duty Staff Nurses for 450-bed fully approved 
teaching hospital. Top salaries with differential for 
evening and night duty. High increments. 40-hour 
week, paid vacation based on length of service, 8 paid 
holidays per year. Accumulative sick plan. Com 
prehensive hospital ization plan. Excellent pension 
plan. Orientation and dynamic inservice program. 
Nurses Association (A.F.L.) governs hours, salaries 
and working conditions. Registration to work in 
California required. Address applications to: Chief 
Nurse, Southern Pacific Memorial Hospital, 1400 Fell 
Street, San Francisco, California 94117. 15-5-6 D 

IN-SERVICE INSTRUCTORS for ward teaching and 
follow up of auxiliary staff. Openings on general 
medicine and in obstetrics. Write Nurse Recruitment 
Officer, Box 1421, Los Angeles County General Hos 
pital, 1200 North State Street, Los Angeles, California 
90033 15-5-3 F 

PREMATURE AND NEWBORN NURSERY NURSES 

Two premature units (one large, one small) and regular 
nurseries need R.N. s for care of high-risk babies. 
Teaching programs. Promotional opportunities. Write: 
Nurse Recruitment Officer, Box 1421, Los Angeles 
County General Hospital, 1200 North State Street, Los 
Angeles, California 90033. 15-5-3 E 

PSYCHIATRIC NURSES Need nurses particularly in 
terested in children and adolescents. Also openings on 
general wards. For details; write: Nurse Recruitment 
Officer, Box 1421, Los Angeles County General Hos 
pital, 1200 North State Street, Los Angeles, California 
90033. 15-5-3 K 

OUTPATIENT NURSES Degree, public health ex 
perience required. Must be interested in teaching pa 
tients and families. For information, write: Nurse 
Recruitment Officer, Box 1421, Los Angeles County 
General Hospital, 1200 North State Street, Los Angeles, 
California 90033. 15-5-3 L 

PROFESSIONAL NURSES Investigate the unlimited 
potential and professional growth offered our nursing 
staff. Ultra-modern equipment and facilities in a new, 
progressive 1 50-bed, air-conditioned hospital. Located 
in a warm, sunny climate 30 minutes from San Fran 
cisco. Top starting salaries, degree and experience re 
cognition, attractive paid benefits, no shift rotation. 
Enquire and compare, write Personnel Director, JOHN 
MUIR MEMORIAL HOSPITAL, 1601 Ygnacio Valley 
Road, Walnut Creek, California 94598. 15-5-67 A 

THE CANADIAN NURSE 63 



UNITED STATES 



UNITED STATES 



UNITED STATES 



Registered Nurses, Career satisfaction, interest and 
professional growth unlimited in modern, JCAH ac 
credited 243-bed hospital. Located in one of Califor 
nia s finest areas, recreational, educational and cul 
tural advantages are yours as well as wonderful 
year-round climate. If this combination is what 
you re looking for, contact us now Staff nurse en 
trance salary above $500 per month; increases to 
$663 per month; supervisory positions at highest 
rates. Special area and shift differentials to $50 per 
month paid. Excellent benefits include free health 
and life insurance retirement, credit union and liberal 
personnel policies. Professional staff appointments 
available in all clinical areas to those eligible for 
California licensure. Write today: Director of Nursing, 
Eden Hospital, 20103 Lake Chabot Road, Castro Val 
ley, California. 15-5-12 

Registered Nurses for 303- bed modern hospital. Po 
sitions available All services, no shift rotation. 
Liberal benefits, advancement opportunities, educa 



tional opportunities in area, equal opportunity 
employer. Apply: Director of Nursing Service, Kaiser 
Foundation Hospitals, San Francisco 15, California. 
Phone (JO 7-4400) 15-5-57 

Registered Nurses California. Expanding, accredit 
ed 303-bed hospital in medical center of Southern 
California. University city. Mountain ocean resort 
area. Ideal year-round climate, smog free. Starting 
salary $6,300. With experience, $6,600. Fringe bene 
fits, shift differential, initial housing allowance. 
Wide variety rentals available. For details on Cali 
fornia License and Visa, write: Director of Nursing, 
Cottage Hospital, 320 W. Pueblo Street, Santa Bar 
bara, California 93105. 15-5-39 A 

REGISTERED NURSES General Duty for 84-bed 

JCAH hospital 1 l /a hours from San Francisco, 2 



Jffi 



pii. 



i T 



BOX 1311 C 
DOROTHY EASLEY, R.N. Nurse Recruitment Officer 

1200 North State Street 

Los Angeles, California 90033 

Telephone 213 225-3115 



Are you looking for career nursing opportunities ? 

Do you want more training? 
Do unusual services appeal to you? 

Then you will want 
more information about our hospital 

We are a university teaching hospital 
for two schools of medicine. 

We have over 200 internes, 300 residents 
and a full time medical staff. 

We are one of the world s 
largest medical centers. 

Starting Salary $560. OO/ month 

Credit for degree 

Shift differential 

Credit for experience 

Outstanding Promotional Opportunities 

Assistant Head Nurse or Charge Nurse 

Head Nurse 
Clinical Specialist; Teaching Assistant; Instructor 



Coronary Care Unit; P.A.R., Intensive Care Units; 

Chest Surgery; Jail; Premature Center; Admitting; 

General Medicine,- O.R.; Diabetic Service; Neurosurgery; 

Metabolic Research; Dermatology; Orthopedics; Eye; Rehab; 

You name it We have it ! 



hours from Lake Tahoe. Starting salary $510/m 
with differentials. Apply: Director of Nurses, Mem 
orial Hospital, Woodland, California. 15-5-491 



CLINICAL INSTRUCTORS 

required 

with preparation and experience. Eligible 
for B. C. Registration. Medical, Surgical 
and Paediatric areas. 

Student enrollment 200 

Apply to: 

Director of Nursing 

ROYAL JUBILEE HOSPITAL 

SCHOOL OF NURSING 

Victoria, B.C. 



DIRECTOR OF NURSING 

For administration of patient care services 
of 100-bed modern, accedited general 
care hospital with medical, surgical, ob 
stetrics and paediatric services. Patient 
care staff comprises 38 graduate nurses, 
20 practical nurses and orderlies and 
5 p.n. trainees, laboratory, X-Ray, physio 
therapy personnel. 

The Director of Nursing would be directly 
responsible to the Administrator. 
Graduation from an approved School of 
Nursing essential with experience or 
preparation in patient care administra 
tion desirable. 

Please direct enquiries or applications 
stating experience, training and references 

to: 

Administrator, 

KOOTENAY LAKE GENERAL 
HOSPITAL 

3 View Street, Nelson, B. C. 



SCHOOL OF NURSING 

ST. THOMAS-ELGIN GENERAL HOSPITAL 

will require 
2 TEACHERS - AUGUST 1967 

DUTIES: Instruction in Science and Medical- 
Surgical Nursing Participation in deve 
lopment of 2 year programme. 

QUALIFICATIONS: University preparation 
in Nursing Education or Public Health. 

SALARY: Commensurate with experience 
and education. 50 students enrolled 
annually. 

For further information contact: 

Director School of Nursing 

ST. THOMAS-ELGIN GENERAL 

HOSPITAL 
St. Thomas, Ont. 



64 THE CANADIAN NURSE 



MARCH 1967 




YOU CAN TELL THAT NURSES HELPED TO DESIGN OUR NURSING UNITS 

Community-General is completely designed for the nurse and the 
maximum development of her professional nursing abilities. 

Unit Clerk Service - 1 6 hours a day 

Automated delivery of supplies 

Maximum supporting services of 
Central Service, Dietary, Housekeeping, 
and others 



COMMUNITY-GENERAL HOSPITAL of Greater Syracuse 

Syracuse, New York 



Orientation Program 

In-Service Program 

Tuition Grants 

Shift Differentials 

Overtime - Paid at time and one half 

Excellent Personnel Policies 



Mail this coupon for information: 

Director of Personnel 

Community-General Hospital of Greater Syracuse 

Broad Road 

Syracuse, New York 13215 

Name 

Street 

City & State , 



MARCH 1967 



Please check present status: 
Student Q R.N. Q LP.N. D Supervisor Q 

THE CANADIAN NURSE 65 



VICTORIA GENERAL HOSPITAL 

HALIFAX, NOVA SCOTIA 

Invites applications from Registered Nurses 
for all services including operating room, 
recovery room, intensive care and emergency 
in completely new wing. 

Salary range for General Staff positions 

$360.00 - $420.00 per month 

and other liberal benefits. 



Direct enquiries to: 
Director of Nursing, 

VICTORIA GENERAL HOSPITAL 

Halifax, Nova Scotia 

3989 



The 

Canadian 
Nurse 



1965 INDEX 

An index of materials appearing 
in Volume 61 of 

THE CANADIAN NURSE 

is now available. 

Write for your copy to 

Miss PIERRETTE HOTTE 

at National Office, 

50 The Driveway, 

Ottawa 4 



UNITED STATES 



UNITED STATES 



Staff Duly positions (Nurs) in private 403-bed 
hospital. Liberal personnel policies and salary. Sub 
stantial differential for evening and night duty. 
Write: Personnel Director, Hospital of The Good 
Samaritan, 1212 Shotto Street, Los Angelei 17, 
California. 15-5-3b 



REGISTERED NURSES If you have a degree from 
an NLN accredited school and one year s experience, 
we start you at $624 a month. Current openings on 
burn services, chest surgery and chest medical units. 
Write: Nurse Recruitment Officer, Box 1421, Los 
Angeles County General Hospital, 1200 North State 
Street, Los Angeles, California 90033. 15-5-3 I 



GENERAL DUTY NURSES - for medical services. May 
have experience in intensive care units and coronary 
care unit if desired. With one year s experience, start 
at $591. Write: Nurse Recruitment Officer, Box 1421, 
Los Angeles County General Hospital, 1200 North 
State Street, Los Angeles, California 90033. 15- 5-3 G 



NURSES California calls! Exciting new programs in 
one of the country s largest medical centers. Openings 
in neuro-surgery and renal dialysis units. Special 
teaching programs on both services Write: Nurse 
Recruitment Officer, Box 1421, Los Angeles County 
General Hospital, 1200 North State Street, Los Angeles, 
California 90033 15-5-3 H 



PROFESSIONAL NURSES with a clinical specialty: 

we hove openings in all major areas. Utilize your 
specialty in the care of patients, not the desk. Write 
for more information: Nurse Recruitment Officer, Box 
1421, Los Angeles, County General Hospital, 1200 
North State Street. Los Angeles, California 90033 

1 5-5-3 J 



NURSES, Registered, for modern 360-bed hospital. 
Openings available in all areas, medicine-surgery, 
delivery room, nursery, and postpartum. Near Wayne 
State University, ana an integral part of the new 
Medical Center. Salary $550 to $635 per month 
plus differential for afternoon and night. Premium 
pay for weekends. Good fringe benefits including 
Blue Cross and Life Insurance. Apply: Personnel 
Director, Hutzel Hospital formerly Woman s Hospital), 
432 East Hancock, Detroit, Michigan 48201. 15-23-1 F 

66 THE CANADIAN NURSE 



NURSE TEAM LEADER POSITIONS in new 372-bed 
fully accredited, General Hospital in resort area. $503 
per month days ana 1 $528 per month evening and 
night shift. Liberal fringe benefits. For descriptive bro 
chure and policies write: L. Sims, North Miami Gene 
ral Hospital, 1701 NE 127th Street, North Miami, 
Florida. 15-10-2 A 



REGISTERED NURSES: for 75-bed air conditioned 
hospital, growing community. Starting salary $330- 
$365/m, fringe benefits, vacation, lick leave, holi 
days, liffl insurance, hospitalization. 1 meal furnish 
ed. Write: Administrator, Hendry General Hospital, 
Clewiston, Florida. 15-10-1 



WEST INDIES 



Registered Graduate Nurses who wish to gain valu 
able and interesting experience in the semi tropical 
country of Haiti. Hopital Albert Schweitzer, Arti- 
bonite Valley near St. Marc is a well-equipped 
modern hospital, 160 average daily census, medical, 
surgical, pediatric wards and daily clinics. Two 
year contract, $150 per month with transportation 
to and from point or origin, maintenance, medical 
care as provided at hospital. Compensatory day off 
for any holiday worked; there are at least 17 na 
tional and religious holidays in Haiti. The nurse is 
entitled to a vacation allowance at the rate of two 
days for each full calendar month worked. Write: 
Miss Walborg L. Peterson, P.O. Box 2213-B, Port-au- 
Prince, Haiti. 17-1-2 



ONTARIO 



Director of Nursing: Applications are invited for the 
position of Director of Nursing effective January I, 
1967, for a 42-bed General Hospital located in the 
heart of Northwestern Ontario. Residence suite availa 
ble. For full particulars write to: Les. J. H. Johnston, 
Administrator, Sioux Lookout General Hospital, P. O. 
Box 909, Sioux Lookout, Ontario. 7119-1 



DIRECTORS 
AND 

ASSISTANT 
DIRECTORS 

WORKSHOPS ON 
PROBLEM-SOLVING 



Learn and practice problem- 
solving skills applied to 
Hospital Nursing Service 

Have you registered? 

Halifax April 11-14, 1967 
Vancouver May 2-5, 1967 

It s later than you think! 



Write to: 

CANADIAN 
50 The Driveway, 
Ottawa 4, Ontario. 
NURSES ASSOCIATION 



MARCH 1967 








GO!... Where the ACTION is! 

Albany Medical Center, that s where. A modern teaching hos 
pital perfectly located in beautiful upstate New York ... on 
the doorstep of New York City s bright lights . . . exciting 
horse racing at Saratoga . . . summer homes of the Philadelphia 
and Boston Symphony Orchestras . . . scenic Lake George . . . 
and the greatest skiing in the East. 

Our nursing opportunities are tops, too. For details, send for 
our free booklet, "Albany Medical Center Nurse." 

Albany Medical Center Hospital 



Mrs. Helen Middleworth, Director, Nursing Service 
Albany Medical Center Hospital 
Albany, New York 12208 

Please send me a free copy of your nursing booklet. 



NAME 



ADDRESS 



CITY 



.STATE ZIP.. 



CAN 




specialization 




education 







I 




recreation 



Specialize at either the 424 bed Grace Central 
Hospital in the new $250 million Detroit Medical 
Center or at the 448 bed Grace Northwest Hospital. 
(Grace is second largest in terms of admissions in 
Michigan.) 

Further your education at nearby Wayne State 
University or one of the many smaller colleges 
nearby. 

Enjoy your leisure time in the heart of the 
cultural and entertainment center of dynamic 
Detroit or enjoy the all-year around sports and 
recreation of Michigan. 

Staff nurses at Grace earn from $500 to $600 
per month for days and $514 to $629 for evening 
and night duty plus very generous fringe benefits. 
Other positions pay even more. For full informa 
tion contact: Director of Nursing. 



GRACE CENTRAL HOSPITAL 

4160 John R. Street, 
Detroit, Michigan 48201 

or 
GRACE NORTHWEST HOSPITAL 

18700 Meyers Road, 
Detroit. Michigan 48235 



68 THE CANADIAN NURSE 




ONTARIO SOCIETY 

FOR 

CRIPPLED CHILDREN 

requires 

Camp Directors 

General Staff Nurses 

Registered Nursing Assistants 

for 
FIVE SUMMER CAMPS 

located near 

OTTAWA COLLINGWOOD 

LONDON PORT COLBORNE 

KIRKLAND LAKE 

Applications are invited from nurses in 
terested in the rehabilitation of physically 
handicapped children. Preference given to 
CAMP DIRECTOR applicants having super 
visory experience and to NURSING ap 
plicants with paediatric experience. 

Apply in writing to: 

Miss HELEN WALLACE, Reg. N., 

Supervisor of Camps, 

350 Rumsey Road, 

Toronto 17, Ontario 



ST. JOSEPH S 

HOSPITAL 

HAMILTON, 

ONTARIO 

A modern, progressive hospital, 
located in the centre of Ontario s 
Golden Horseshoe 
invites applications for 

GENERAL STAFF 
NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 

Immediate openings are avail 
able in Operating Room, Psy 
chiatry, Intensive Care Coro 
nary Monitor Unit, Obstetrics, 
Medical, Surgical and Paediatrics. 

For further information write to: 
THE DIRECTOR OF NURSING 

ST. JOSEPH S HOSPITAL 

Hamilton, Ontario 




your diploma 

means something 

at Presbyterian 

Hang on to that diploma. It s 
probably the most important 
piece of paper you ll ever earn. 
Ifs your certificate of profession 
alism. Make the most of your 
diploma by choosing a hospital 
where your professionalism, your 
skill, your individual contributions 
are appreciated. 




PRESBYTERIAN HOSPITAL CENTER 
ALBUQUERQUE, NEW MEXICO 87106 

"Starting salary to $555 a month 
"Expanding, progressive 

500-bed hospital 
" Personal orientation program 
"Liberal fringe benefits 
"Continuing educational programs 
"Airline travel paid 
"Two universities 
* "Growing metropolitan area 
"Twenty minutes from nearby 

mountain ski area 

EQUAL OPPORTUNITY EMPLOYER 
Mail coupon or call collect (505-243-941 1, Eit. 219) 



Mrs. Susan Dicke, Director of Nurse Recruitment 
Presbyterian Hospital Center, Department B 
Albuquerque, New Mexico 87106 

Please mail me more information about nursing 
at Presbyterian Hospital Center and how 1 may 
make the most of my diploma there. 



Name 



Address. 



School of Nursmg_ 
Year of Graduation . 



.Month, 



MARCH 1967 



THE HAMILTON AND DISTRICT SCHOOL OF NURSING 

SPONSORED BY 

THE HAMILTON HEALTH ASSOCIATION 

INVITES APPLICATIONS FOR THE POSITION OF 

INSTRUCTOR 

QUALIFICATIONS A University degree and graduate experience in one or more fields of nursing. 

Eligibility for Nurse Registration in Ontario. 

The fourth group of students will be enrolled in September 1967. Additional teachers will be required 
since the maximum enrolment is expected to be reached this year. 

THE SCHOOL PROGRAM 

CONTROL The entire curriculum which covers 2 calendar years is planned and controlled by the school. 

Clinical experience, practice and observation is provided in: 

1) The H. H. A. complex of hospitals. 

2) The Joseph Brant Memorial Hospital, Burlington. 

3) The Oakville Trafalgar Hospital, Oakville. 

4) The Ontario Hospital, Hamilton. 

5) Community agencies in the area. 

FOR FURTHER INFORMATION WRITE TO: 
The Director, 

HAMILTON AND DISTRICT SCHOOL OF NURSING, 

Box 590, Hamilton, Ontario 



OSHAWA 
GENERAL HOSPITAL 

GENERAL DUTY NURSES FOR 
ALL DEPARTMENTS 

Starting salary for Ontario Regis 
tered nurses $400 with 5 annual 
increments to $480 per month. 
Credit for acceptable previous 
service one increase for two 
years, two increases for four or 
more years. 

Non-registered $360.00 
Rotating periods of duty 3 
weeks vacation 8 statutory 
holidays. 

One day s sick credit per month 
beginning in the 7th month of 
service cumulative to 45 days. 
Pension Plan and Group Life 
Insurance Hospital pays 50% 
of Medical, Blue Cross and Hos 
pital Insurance premiums. 

Apply to: 
Director of Nursing 

OSHAWA GENERAL HOSPITAL 

Oshawa, Ontario 



STAFF NURSE POSITIONS 
Salary Range $482-5620 

with maximum starting $539 on day shift, 
$592 evening and/or night shifts. Credit 
given for education and/or experience. 
Opportunity to gain knowledge and skill 
in a specialized cancer research hospital. 
Registration in Texas required. Excellent 
personnel benefits include: 3 weeks vaca 
tion, holidays, cumulative sick leave, 
laundry of uniforms furnished, retirement 
and Social Security programs, Hospitaliza- 
rion, Life and Disability Income Insurance 
available. Equal opportunity employer. 

For application and additional information 
Write to : 

Personnel Manager 

THE UNIVERSITY OF TEXAS 

M.D. ANDERSON HOSPITAL AND 

TUMOR INSTITUTE 

Texas Medical Center 
Houston, Texas 77025 



RIVERSIDE 

HOSPITAL 

OF OTTAWA 

A new, air-conditioned 340-bed 
hospital. Applications are called 
for Nurses for the positions of: 

HEAD NURSE Operating Room 
ASSISTANT HEAD NURSES 
GENERAL STAFF NURSES 

and 

REGISTERED NURSING ASSISTANTS 

Address all enquiries to: 
Director of Nursing 

RIVERSIDE HOSPITAL OF OTTAWA 

1967 Riverside Drive, 
Ottawa, Ontario 



MARCH 1967 



THE CANADIAN NURSE 69 




YORK COUNTY HOSPITAL 

NEWMARKET, ONTARIO 
HOSPITAL: 

A newly expanded 257 bed hospital with such progressive 

patient care concepts as a 12-bed I.C.U., 22-bed psychiatric 

and 24-bed self care unit. 
IDEAL LOCATION: 

45 minutes from downtown Toronto, 15-30 minutes from 

excellent summer and winter resort areas. 
SALARIES: 

Registered Nurses: $372-$447 per month. 

Registered Nursing Assistants: $277-$310 per month. 
BENEFITS INCLUDE: 

Furnished apartments, medical and hospital insurance, group 

life insurance, pension plan, 40 hour week. 

Please address all enquiries to: 
Director of Nursing 

YORK COUNTY HOSPITAL 

596 Davis Drive 
Newmarket, Ontario 



ADDITIONAL CLINICAL TEACHERS 

required 

to assist in Developing New Curriculum and a 

Regional School. 
School of Nursing Building is New 

and well equiped. 

Salaries and Fringe Benefits at Metropolitan Level. 
Qualifications B.Sc.N. 

or 
Diploma in Nursing Education, 



GENERAL STAFF NURSES 

Required for all Services 
Salaries and Fringe Benefits at Metropolitan Level. 



Apply to : 
DIRECTOR OF NURSING 

BRANTFORD GENERAL HOSPITAL 

Brantford, Ontario 



MAIMONIDES HOSPITAL 
AND HOME FOR THE AGED 

AN OPPORTUNITY.... 

A CHALLENGE 

A NEW EXPERIENCE.... 

SUPERVISORS, STAFF NURSES, NURSING 
ASSISTANTS, INSTRUCTORS, PSYCHIATRIC 
NURSE: 

We invite you to join the nursing staff of New Mai- 
monides. 

LIBERAL VACATION .... HEALTH AND 
PENSION PLANS .... SALARIES COM 
MENSURATE WITH RECOGNIZED SCALES 

Apply to: 

DIRECTOR OF NURSING 

5795 Caldwell Avenue 
Montreal 29, Quebec 



DIRECTOR 
OF SCHOOL OF NURSING 

Applications are invited for the above position in a 
School of Nursing intending to revise programme in 
Fall of 1967 to a two year programme with a third 
year of experience in hospital nursing service. The 
School of Nursing is a new self-contained educational 
building, opened in 1964, with enrollment of ap 
proximately 140 students. 

Trent University is situated in Peterborough. 

Minimum requirement Bachelor s Degree. Salary 
will be commensurate with qualifications and ex 
perience. 

For further details apply to: 
Chairman of Nursing Education Committee, 

PETERBOROUGH CIVIC HOSPITAL 

Peterborough, Ontario 



70 THE CANADIAN NURSE 



MARCH 1967 



PALO ALTO-STANFORD 
HOSPITAL CENTER 

Located on the beautiful campus of Stanford University in Palo Alto, California. 




"We invite you to join our professional staff and to gain unparalled experiences in 
nursing." 

For additional information 

NAME: 

ADDRESS: 

CITY: STATE: 

SERVICE DESIRED: 

to p ALO ALTO-STANFORD HOSPITAL CENTER 

Personnel Department 

300 Pasteur Drive 
Palo Alto, California 



ASSISTANT DIRECTOR 
OF NURSING 

Applications are invited for the 
above position in a fully ac 
credited 163-bed General Hos 
pital in beautiful Northern On 
tario. 

Desirable qualifications should 
include B.S.N. Degree with ex 
perience in supervision. 

For further information, 
Writ e to : 

Director of Nursing 

KIRKLAND and DISTRICT HOSPITAL 

Kirkland Lake, Ontario. 



VICTORIA HOSPITAL 

LONDON, ONTARIO 

Modern 1,000-bed hospital 
Requires 

Registered Nurses for 
all services 

and 

Registered 
Nursing Assistants 

40 hour week Pension plan 
Good salaries and Personnel 
Policies. 

Apply: 
Director of Nursing 

VICTORIA HOSPITAL 

London, Ont. 



ST. JOSEPH S HOSPITAL 

TORONTO, ONTARIO 

REGISTERED NURSES 

and 

REGISTERED 
NURSING ASSISTANTS 



700-bed fully accredited hospital provides 
experience in Operating Room, Recovery 
Room, Intensive Care Unit, Pediatrics 
Orthopedics, Obstetrics, General Surgery 
and Medicine. 

Orientation and Active Inservice program 
for all staff. 

Salary is commensurate with preparation 
and experience. 

Benefits include Canada Pension Plan, 
Hospital Pension Plan, Group Life Insu 
rance. Sick leave 12 days after one 
year, Ontario Hospital Insurance 50% 
payment by hospital. 

Rotating Periods of duty 40 hour week, 
8 statutory holidays- annual vacation 
3 weeks after one year. 

Apply: 

Assistant Director of 
Nursing Service 

ST. JOSEPH S HOSPITAL 

30 The Queensway 
Toronto 3, Ontario 



MARCH 1967 



THE CANADIAN NURSE 71 



THE HOSPITAL 



FOR 



SICK CHILDREN 




OFFERS: 



1. Satisfying experience. 

2. Stimulating and friendly en 
vironment. 

3. Orientation and In-Service 
Education Program. 

4. Sound Personnel Policies. 

5. Liberal vacation. 

APPLICATIONS FOR REGISTERED 
NURSING ASSISTANTS INVITED. 

For detailed information 
please write to: 

The Assistant Director 

of Nursing 
AUXILIARY STAFF 

555 University Avenue 
Toronto, Ontario, Canada 



HUMBER MEMORIAL HOSPITAL 

HOSPITAL 

Newly expanded 350-bed hospital. Progressive patient care con 
cept. 

SALARY 

General Staff Nurses (Currently Registered in Ontario) $400.00 - 
$480. 5-increments. 

Registered Nursing Assistants (Currently Registered in Ontario) 
$295.00 - $331.00, 3 increments. 

HOUSING 

Furnished apartments available at subsidized rates. 

JOB SATISFACTION 

High quality patient care and friendly working environment. We 
appreciate our personnel and encourage their professional develop 
ment. 

You are invited to enquire concerning employment opportunities to: 
Director of Nursing 

HUMBER MEMORIAL HOSPITAL 

200 Church Street, Weston, Ontario 
Telephone 249-8111 (Toronto) 



CALGARY GENERAL HOSPITAL 

requires immediately 

REGISTERED GENERAL DUTY NURSES 



This is a modern 1,000-bed hospital including a new 
200-bed convalescent-rehabilitation section. Benefits 
include Pension Plan, sick leave, and shift differen 
tial plus a liberal vacation policy and salary range 
$360 - $420 per month commensurate with training 
and experience. 

Apply to: 

Director of Nursing Service 

CALGARY GENERAL HOSPITAL 

Calgary, Alberta 



72 THE CANADIAN NURSE 



MARCH 1967 



there are over 

200,000 more 

who need your help! 




REGISTERED NURSES PUBLIC HEALTH NURSES 
CERTIFIED NURSING ASSISTANTS 

Have you considered a Career with the... 

Indian Health Services of MEDICAL SERVICES 
DEPARTMENT OF NATIONAL HEALTH AND WELFARE 

for further information write to: MEDICAL SERVICES, DEPARTMENT OF NATIONAL HEALTH AND WELFARE, OTTAWA, CANADA 



DIRECTOR OF NURSING 

Applications are invited 
for the 

POSITION OF DIRECTOR OF NURSING 

The Director of Nursing will be responsible for 
the administration of all nursing services within 
the hospital. The hospital currently operates 
375 beds and is undergoing extensive moderni 
zation and expansion costing $3,750,000. There 
is a furnished apartment available at a mini 
mum rental. A 140 student School of Nursing 
housed in a modern residence and operated 
by the hospital is the responsibility of a Director 
of Nursing Education. 

Address enquiries to: 
DOUGLAS M. McNABB, Administrator 

McKELLAR GENERAL HOSPITAL 

Fort William, Ontario 




THE SCARBOROUGH 
GENERAL HOSPITAL 

Invites applications from General Duty Nurses. 
Excellent personnel policies. An active and stimulat 
ing In-Service Education and Orientation Programme. 
A modern Management Training Programme to as 
sist the career-minded nurse to assume managerial 
positions. Salary is commensurate with experience 
and ability. We encourage you to take advantage 
of the opportunities offered in this new and expand 
ing hospital. 

For further information write to: 

Director of Nursing 
SCARBOROUGH GENERAL HOSPITAL 

Scarborough, Ontario 



MARCH 1967 



THE CANADIAN NURSE 73 




HOSPITAL: 

A newly expanded 257 bed hospital with such progressive 
care concepts as a 1 2-bed I.C.U., 22-bed psychiatric and 
24-bed self care unit. 

IDEAL LOCATION: 

45 minutes from downtown Toronto, 15-30 minutes from ex 
cellent summer and winter resort areas. 

SALARIES: 

Registered Nurses: $400.00 - $480.00 per month. 

Registered Nursing Assistants: $295.00 - $331.00 per month. 

FURNISHED APARTMENTS: 

Swimming pool, tennis courts, etc. (see above) 

OTHER BENEFITS: 

Medical and hospital insurance, group life insurance, pension 
plan, 40 hour week. 

Please address all enquiries to: 

DIRECTOR OF NURSING 

YORK COUNTY HOSPITAL 

596 Davis Drive 
Newmarket, Ontario 



REGISTERED NURSES 

Lutheran General Hospital, Park Ridge, Illinois is a 
new 587-bed General Hospital, located in a pleasant 
suburb of Chicago. 

The hospital is modern with a wide range of services 
to patients, including Hyperbaric Oxygen Unit. Low- 
cost modern housing next to the hospital is available. 
The hospital is completely air-conditioned. 

Annual beginning salary is from $6,000 plus shift 
differential pay. Regular salary increments at six 
months of service and yearly thereafter. Sick leave 
and other fringe benefits are also available. 

Write or call collect: 
Director of Nursing Services 

LUTHERAN GENERAL HOSPITAL 

PARK RIDGE, ILLINOIS 60068 

Telephone: 692-2210 Ext. 211 
Area Code: 312 



mm 



NURSE- 
ANESTHETIST-OB- 



For 350 Bed Community 
Teaching Hospital, 35 min 
utes from Metropolitan New 
York. 

Excellent Salary 
+ Benefits 

In-service Education 

8 Paid Holidays per year 

Tuition Refund Program 

12 Paid Sick Days 

per year 

Free Life and 

Disability Insurance 

Blue Cross Coverage 



Send Resume to: 

Box CN 1433, 

125 West 41 St. 

New York NY 10036 

An Equal Opportunity 
Employer M/F 



REGISTERED 
NURSES 

Highand Park General Hospital 
is a 300-bed General Hospital 
located within 15 minutes of 
downtown Detroit. It is fully ap 
proved by the Joint Commission 
on Accreditation of Hospitals. 
Salary range for Staff Nurses is 
$6,484.40 to $7,633.60 annually 
depending on schedule. Week 
end bonus of $5.00 per shift in 
excess of one weekend per 
month for part time nurses. 

Call or write: 
Assistant Director of Nursing 

HIGHLAND PARK GENERAL 
HOSPITAL 

Highland Park, Michigan 
883-7000, Ext. 576 



TJ1 
A 




says 

life at Mary Fletcher 
Hospital Medical Center 
is all work & no play? 

Uncrowded Vermont is for 
those who like outdoor fun. 
Sailing, swimming*- skiing, 
tennis, golf, are only 
utes away from Mary 
cher Hospital on the shore 
of lovely Lake Champtain?< 
Combine an exciting career 
with off-duty recreation and! 
the cultural advantages ofj 
an attractive college cpm-f 
munity. Excellent starting 
salaries, liberal fringe bene 
fits, clinical affiliation with 
Univ. of Vermont College of 
Medicine. MFH serves as the 
primary teaching and refer 
ral center for all of northern 
New England. 

I ~~ " "" ~ ~~ ~~ """ "" ~~ ~~ "~~ 

Personnel Office, Dept. 401 

Mary Fletcher Hospital Medical Center 

Burlington, Vermont 05401 

Please tell me more about career opportuni 
ties at Mary Fletcher Hospital Medical Center 
and send me literature about Vermont 
The Beckoning Country. 

NAME 
ADDRESS 




74 THE CANADIAN NURSE 



MARCH 1%; 



OPPORTUNITY FOR 



GROWTH 

CHANGE 
SPECIALIZATION 



TORONTO GENERAL HOSPITAL 

Large centrally located University Teaching Hospital 

> CONTINUE YOUR PROFESSIONAL GROWTH 

Planned orientation programme 

Continuing in-service programmes 

Opportunities of a research and teaching hospital 

BROADEN EXPERIENCE 
Positions available: 

General medicine Obstetrics Operating Room 

General Surgery Gynaecology Recovery Room 

Specialty units and intensive care Cardiovascular 
Respiratory Neurosurgery 

ENJOY ADVANTAGES OF LIBERAL PERSONNEL POLICIES 

- Excellent patient care facilities 

Salaries seated to qualifications and experience 

3 weeks vacation, statutory holidays, cumulative sick leave 

Life insurance, hospitalization, retirement programme 
Uniforms laundered free 



For additional information, 

Director of Nursing 

TORONTO GENERAL HOSPITAL 

101 College Street, Toronto 2, Ontario 



THE MACK SCHOOL 
OF NURSING 



Applications are invited from teachers interested in 
developing a progressive educational programme in 
this new Regional School, located in the Niagara 
Peninsula. Applicants with baccalaureate degree 
preferred. Diploma in nursing education and working 
toward a degree accepted. 

Good personnel policies. 



Apply to: 
The Principal, 

THE MACK SCHOOL OF NURSING, 

Queenston Street, 
St. Catharines, Ontario 



THE PLACE TO BE IN 
CENTENNIAL YEAR! 



OTTAWA CIVIC HOSPITAL 
Ottawa, Ontario 

Enjoy life in green and pleasant Ottawa. Daily 
train and bus service to Expo 67! Challenging 
work in a modern teaching Hospital of 1087 
beds, where administration is progressive and 
staff participation encouraged, In-Service Educa 
tion program well established. Excellent salaries, 
personnel policies and fringe benefits to: 

REGISTERED NURSES 

for all services including Operating Room and 
Psychiatry. 



Apply in writing to: 
Miss B. JEAN MILLIGAN, Reg.N., M.A. 

ASSISTANT DIRECTOR. 



MARCH 1967 



THE CANADIAN NURSE 75 



GRADUATE NURSES 

Eligible for registration in the 
Province of Ontario. 

Various positions available as SUPER 
VISORS, HEAD NURSES, and GENERAL 
DUTY NURSES. Excellent opportunities for 
advancement in oil areas of modern, 
newly expanded 1,000-bed General Hos 
pital, including O.R. and Recovery, Inten 
sive Care, Emergency, Central Supply, 
Medical and Surgical Units. 

Please contact: 

Director of Nursing 

HENDERSON GENERAL 

HOSPITAL 
Hamilton, Ontario 



DIRECTOR OF NURSING 

Required for 37 bed active hospital in 
town of 1,700 pop. midway between 
Calgary and Lethbridge, paved hiwy. 
wheat growing area, close to foothills. 
Training or experience in Nurse Adminis 
tration would be beneficial. Increase in 
usage of all facilities in last 6 months. 
Salary to be negotiated. Suite in nurses 
residence. Insurance and pension group. 
Present Director retiring. 

Apply in writing to: 

Administrator, 

MUNICIPA